Nephrotic Syndrome is a nonspecific kidney disorder, featured symptoms of which are proteinuria, hypoalbuminemia and edema. Cause of the disease is the damage to the glomeruli.
In Nephrotic Syndrome, inflammation or hyalinization of glomeruli causes an increase in permeability of the capillary walls. That allows proteins such as albumin, antithrombin and immunoglobulins to pass through the cell membrane and appear in urine, which is the reason of proteinurina.
Proteinurina will lead to hypoalbuminemia, that is, low protein content in blood. Serum oncotic pressure is lower than that in tissues, so fluid will move form blood to tissues. Patients present edema, which first occur around the eyes, characteristically in the morning. Then develop to over the legs, pleural cavity and peritoneal cavity. Eventually, the symptom progresses to anasarca.
Proteinurina and hypoalbuminemia have an effect on hyperlipidaemia: hypoproteinemia stimulates protein synthesis in the liver, resulting in the overproduction of lipoproteins; lipoprotein lipase leaks through the urine, so lipid catabolism is decreased. Thus, patients have the symptom of hyperlipidaemia.
Nephrotic Syndrome can be caused by primary Nephrotic Syndrome (primary glomerulonephritis) or complication of other diseases (secondary Nephrotic Syndrome)
Minimal Change Disease (MCD)
It is a kind of mild glomerular lesion, which only can be viewed by an electron microscope. Pronounced symptom of the disease is massive proteinuria. It often occurs to children and the prognosis is good.
Focal Segmental Glomerulosclerosis (FSGS)
It is a cause of Nephrotic Syndrome in children and adolescents, as well as an important cause of kidney failure in adults. In Focal Segmental Glomerulosclerosis, only part of patients’ glomeruli is damaged. It is characterized by the appearance of tissue scar in the glomeruli.
Membranous Glomerulonephritis (MGN)
This disease affects adult in 30s to 50s. It’s the second most common cause of Nephrotic Syndrome in adults followed by Focal Segmental Glomerulosclerosis. MGN is caused by immune complex formation in the glomeruli and progresses slowly. Secondary glomerulonephritis
It is a complication of diabetes characterized by Nephrotic Syndrome and diffuse glomerulosclerosis.
Systemic Lupus Erythematosus
It is a systemic autoimmune disease that can affect any part of the body. The deposit of immunocomplexes that is typical to this disease.
Gold salts can cause a more or less important loss of proteins in urine as a consequence of metal accumulation. Penicillin is nephrotoxic in patients with kidney failure and captopril can aggravate proteinuria.
Swelling or edema
Firstly, edema occurs around your eyes and in your ankles and feet. Then it progresses to pleural cavity and peritoneal cavity causing pleural effusion and peritoneal effusion even anasarca.
Small bubbles appear in urine and last along time. That’s because the presence of protein lowers the surface tension.
Excess fluid retains in patients’ body so they gain weight.
Shortness of breath
Sever edema causes fluid buildup in the lungs leading to pulmonary edema.
There is no cure for the disease, but medications can help patients alleviate the symptoms and delay disease progress.
Corticosteroids are strong anti-inflammatory medicines. They can reduce swelling in the body caused by Nephrotic Syndrome. Corticosteroids are in conductive to restore the kidney's normal function and remove extra fluid from the body.
Diuretics reduce fluid buildup in the body. Patients should take right dose of medicine, as too much fluid reduction in a short time may induce further kidney damage and low blood pressure.
ACEI and ARBs
Medicines, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) help to lower blood pressure and reduce the amount of protein lost in the urine to slow the progress of the disease.
The prognosis for Nephrotic Syndrome under treatment is generally good although this depends on the underlying cause, the age of the patient and their response to treatment. It is usually good in children, because Minimal Change Disease responds very well to steroids and does not cause chronic renal failure. Any relapses that occur become less frequent over time; the opposite occurs with Mesangiocapillary Glomerulonephritis, in which the kidney fails within three years of the disease developing.
Other causes, such as Focal Segmental Glomeruloscleros are frequently lead to end stage renal disease. Factors associated with a poorer prognosis in these cases include level of proteinuria, blood pressure control and kidney function (GFR). Without treatment, Nephrotic Syndrome has poor prognosis, especially rapidly progressing glomerulonephritis, which leads to acute kidney failure after a few months.
The prospective condition of Nephrotic Syndrome patients varies and is largely dependent on the underlying cause of their disease. Some patients recover spontaneously while others need specific treatments. All patients take active treatment accompanied by proper homey remedy could improve their conditions. We hope that the knowledge in this article could help you in your future treatment. If you need any help, you can contact our online doctor for help.
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