Nephrotic Syndrome
Also known as: Nephrosis, Minimal change disease (childhood form)
Nephrotic syndrome is a kidney condition in which the filtering units leak large amounts of protein from the blood into the urine. The loss of protein, particularly albumin, causes fluid to shift out of the bloodstream into the tissues, producing marked swelling of the legs, abdomen, and face. It also disturbs cholesterol levels and increases the risk of infections and blood clots. In children, nephrotic syndrome is most often caused by minimal change disease, which usually responds very well to steroids. In adults, causes include membranous nephropathy, focal segmental glomerulosclerosis, diabetes, and lupus. Treatment addresses the underlying cause while controlling swelling and protecting against complications.
At a Glance
- Common symptoms
- Marked swelling of the ankles, legs, and around the eyes, often worse in the morning for the face and in the evening for the legs, Swelling of the abdomen (ascites) and sometimes the scrotum or labia, Foamy or frothy urine
- Main treatments
- Corticosteroids, which produce remission in most children with minimal change disease, and other immune-suppressing drugs for steroid-resistant or relapsing disease, Treatment targeted to the underlying cause in adults, such as rituximab for membranous nephropathy or tighter diabetes control, ACE inhibitors or ARBs to reduce protein leakage and control blood pressure
- Category
- Urological · Uncommon; the most frequent form occurs in young children and typically responds to treatment
- See a doctor if
- New or worsening swelling of the legs, face, or abdomen
Symptoms
Causes
- Minimal change disease, the most common cause in children
- Focal segmental glomerulosclerosis (FSGS) and membranous nephropathy in adults
- Diabetic kidney disease
- Lupus and other autoimmune diseases
- Infections such as hepatitis B, hepatitis C, HIV, and malaria
- Certain medications (NSAIDs, some cancer drugs), amyloidosis, and some cancers
Risk Factors
- Young childhood, particularly between ages two and six
- Diabetes, lupus, or amyloidosis
- Chronic viral infections
- Long-term use of NSAIDs or certain other medications
- A family history of kidney disease or inherited glomerular disorders
Diagnosis
- Urine tests showing very high protein levels, usually measured on a spot sample or 24-hour collection
- Blood tests showing low albumin, high cholesterol, and assessment of kidney function
- Tests for underlying causes, including blood sugar, autoimmune markers, and viral screens
- Kidney ultrasound
- Kidney biopsy in most adults and in children who do not respond to steroids
Treatment
- Corticosteroids, which produce remission in most children with minimal change disease, and other immune-suppressing drugs for steroid-resistant or relapsing disease
- Treatment targeted to the underlying cause in adults, such as rituximab for membranous nephropathy or tighter diabetes control
- ACE inhibitors or ARBs to reduce protein leakage and control blood pressure
- Diuretics to reduce swelling, with careful monitoring
- Statins for high cholesterol and anticoagulants when clot risk is high
- Vaccinations and prompt treatment of infections, since nephrotic syndrome lowers immune defenses
- Supportive: a low-salt diet to limit fluid retention, and moderate (not high) protein intake guided by a dietitian
Prevention
- Most cases cannot be prevented, but relapses and complications can be reduced
- Keep diabetes and blood pressure under tight control
- Avoid NSAIDs and other medications that stress the kidneys unless cleared by your doctor
- Stay up to date with vaccinations, particularly pneumococcal and influenza
- Learn to check urine protein at home with dipsticks if advised, so relapses are caught early
When to See a Doctor
- New or worsening swelling of the legs, face, or abdomen
- Persistently foamy urine
- Fever, abdominal pain, or feeling very unwell while swollen (risk of serious infection)
- Sudden leg pain and swelling, chest pain, or breathlessness (possible blood clot, emergency)
- A child with puffy eyes and swollen legs, even if otherwise well
Frequently Asked Questions
Related Conditions
Have questions about Nephrotic Syndrome?
Ask Mother Nature AI for personalized, evidence-based guidance.
Ask about Nephrotic SyndromeMedical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.
Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.