Table of ContentsView AllTable of ContentsCausesSymptomsComplicationsDiagnosisTreatmentIs It Curable?
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Complications
Diagnosis
Treatment
Is It Curable?
Treatment approaches for nephrotic syndrome are geared toward inducing remission. In some patients, this requires drug therapy; in others, there is spontaneous remission. Treatment aims to prevent kidney damage and potentially severe complications like deep vein thrombosis (DVT) and kidney failure.
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Nephrotic vs. Nephritic Syndrome
What Causes Nephrotic Syndrome?
Primary Nephrotic Syndrome
Primary nephrotic syndrome is also known as idiopathic nephrotic syndrome because the underlying causes of these diseases are unknown (idiopathic).
These include:
Secondary Nephrotic Syndrome
Secondary nephrotic syndrome accounts for around 10% of nephrotic syndrome cases.It is associated with diseases that collaterally damage the kidneys. These include autoimmune diseases that damage the kidney with systemic inflammation or diseases that cause the obstruction of blood vessels, including those of the kidneys.
Common causes of secondary nephrotic syndrome include:
Symptoms of Nephrotic Syndrome
These conditions together cause the symptoms commonly seen in people with nephrotic syndrome, including:
Nephrotic Syndrome in Children
Nephrotic syndrome is not very common in children. According to the National Institutes of Health, fewer than 5 in 100,000 children worldwide develop nephrotic syndrome each year. Children of any age can get nephrotic syndrome, but boys between the ages of 2 and 7 are most commonly affected.
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Nephrotic Syndrome in Adults
Nephrotic syndrome is even less common in adults, affecting 3 in every 100,000 people in the United States each year.
In adults, the first sign is usually swelling of the lower extremities, arms, hands, and genitals (referred to as dependent or gravitational edema).
However, the early signs are often subtle and easily attributed to other causes, such as heart disease. The swelling and subsequent weight gain can also be missed if the person is overweight or hasobesity.
In some cases, nephrotic syndrome is only recognized when symptoms of a severe complication, like kidney failure or a blood clot, occur.
Complications of Nephrotic Syndrome
Left untreated, the combination of proteinuria, hypoalbuminemia, hyperlipidemia, and edema can affect multiple organ systems. This can cause adverse changes in blood pressure, blood composition, the volume of body fluids, and the balance ofelectrolytes(charged minerals like sodium, calcium, and potassium) in the body.
Some of the more serious complications of nephrotic syndrome include:
How Long Can I Live With Nephrotic Syndrome?
In contrast, people with secondary nephrotic syndrome have a lower risk of death than those with primary nephrotic disease but a greater risk of progression toend-stage kidney diseasewithin three years (35% vs. 8%).
What Are the Signs of Kidney Failure?
How Nephrotic Syndrome Is Diagnosed
The diagnosis of nephrotic syndrome starts with a review of your medical history and a physical examination to check for signs of edema. This includes pressing on swollen tissues with a thumb to see if it leaves an indentation.
Additional tests would be ordered to diagnose the possible causes of nephrotic syndrome and to check for possible complications.
This may involve:
Nephrotic Syndrome Treatment Options
The treatment of nephrotic syndrome is focused largely on managing symptoms and avoiding disease progression. This may involve medications and nutritional therapies that can help restore protein, albumin, cholesterol, and fluid levels back to normal.
Other treatments may be prescribed depending on the underlying cause of nephrotic syndrome. A kidney specialist known as anephrologistoversees the treatment.
Medications
Among the drug options:
Managing Nephrotic Syndrome With Diet
Nephrotic syndrome is not treated with drugs alone. This is especially true with conditions like hypoalbuminemia, which is mainly treated with diet. Other dietary interventions can increase protein and lower cholesterol levels in the blood.
Dietary plans for people with nephrotic syndrome need to be tailored and managed to ensure that the therapeutic and nutritional goals are met. Working with adietitianor qualifiednutritionistoften helps.
During acute illness, the following dietary measures are usually taken:
Even during periods of remission, good eating habits may help reduce your risk of a relapse.
What Is the Best Diet for Kidney Disease?
Is Nephrotic Syndrome Curable?
This is not to say that all people experience nephrotic syndrome in the same way.
While many people with nephrotic syndrome can achieve remission with treatment, others may achieve “spontaneous remission,” during which the disease will suddenly clear on its own.
This is especially common with primary nephrotic syndrome, in which 30% of people will experience spontaneous remission while 30% will progress to kidney failure.
In other cases, nephrotic syndrome is not curable. This includes children with congenital nephrotic syndrome who tend to have progressively worsening symptoms and an increased risk of kidney failure.
Summary
Nephrotic syndrome is a disease that damages the filtering units of the kidneys called glomeruli resulting in these four conditions—proteinuria, high cholesterol, low blood albumin, and edema.
There are primary causes that directly damage the kidneys and secondary causes in which another disease indirectly damages the kidneys. Symptoms include fatigue, foamy urine, weight gain, puffy face, and swollen legs and feet.
Nephrotic syndrome can be diagnosed with a physical exam and a combination of urine and blood tests. The treatment involves medications and diet that help ease symptoms and avoid disease progression. Some cases resolve spontaneously.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in adults.Verma PR, Patil P.Nephrotic syndrome: a review.Cureus.2024;16(2):e53923. doi:10.7759/cureus.53923Busuioc RM, Mircescu G.Nephrotic syndrome complications – new and old. Part 1.Maedica (Bucur).2022;17(1):153–168. doi:10.26574/maedica.2022.17.1.153MedlinePlus.Acute nephritic syndrome.Kodner C.Diagnosis and management of nephrotic syndrome in adults.Am Fam Physician.2016;93(6):479-485.Nishi S, Ubara Y, Utsunomiya Y, et al.Evidence-based clinical practice guidelines for nephrotic syndrome 2014.Clin Exp Nephrol.2016;20:342–370. doi:10.1007/s10157-015-1216-xMedlinePlus.Minimal change disease.Zhang C, Leng L, Zhang X, Zhao Y, Li Z.Comprehensive identification of immune-associated biomarkers based on network and mRNA expression patterns in membranous glomerulonephritis.J Transl Med.2018;16:210. doi:10.1186/s12967-018-1586-4Greenhall GHB, Salama AD.What is new in the management of rapidly progressive glomerulonephritis?Clin Kidney J.2015;8(2):143–150. doi:10.1093/ckj/sfv008American Kidney Fund.Nephrotic syndrome treatments, causes & symptoms.National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in children.National Health Service (UK).Nephrotic syndrome in children.University of California San Francisco.06. Nephrotic syndrome.Jeele MOO, Adan AM.Nephrotic syndrome presented as a portal vein thrombosis: a case report.Ann Med Surg (Lond).2023;85(5):2112–2114. doi:10.1097/MS9.0000000000000482Kolb A, Gallacher PJ, Campbell J, et al.A national registry study of patient and renal survival in adult nephrotic syndrome.Kidney Int Rep. 2021:6(2):449-459. doi:10.1016/j.ekir.2020.10.033Lella G, Pecoraro L, Benetti E, et al.Nutritional management of idiopathic nephrotic syndrome in pediatric age.Med Sci (Basel).2023;11(3):47. doi:10.3390/medsci11030047Uwaezuoke SN.Steroid-sensitive nephrotic syndrome in children: triggers of relapse and evolving hypotheses on pathogenesis.Ital J Pediatr.2015;41:19. doi:10.1186/s13052-015-0123-9Lionaki S, Mantios E, Tsoumbou I, et al.Clinical characteristics and outcomes of adults with nephrotic syndrome due to minimal change disease.J Clin Med.2021;10(16):3632. doi:10.3390/jcm10163632
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in adults.Verma PR, Patil P.Nephrotic syndrome: a review.Cureus.2024;16(2):e53923. doi:10.7759/cureus.53923Busuioc RM, Mircescu G.Nephrotic syndrome complications – new and old. Part 1.Maedica (Bucur).2022;17(1):153–168. doi:10.26574/maedica.2022.17.1.153MedlinePlus.Acute nephritic syndrome.Kodner C.Diagnosis and management of nephrotic syndrome in adults.Am Fam Physician.2016;93(6):479-485.Nishi S, Ubara Y, Utsunomiya Y, et al.Evidence-based clinical practice guidelines for nephrotic syndrome 2014.Clin Exp Nephrol.2016;20:342–370. doi:10.1007/s10157-015-1216-xMedlinePlus.Minimal change disease.Zhang C, Leng L, Zhang X, Zhao Y, Li Z.Comprehensive identification of immune-associated biomarkers based on network and mRNA expression patterns in membranous glomerulonephritis.J Transl Med.2018;16:210. doi:10.1186/s12967-018-1586-4Greenhall GHB, Salama AD.What is new in the management of rapidly progressive glomerulonephritis?Clin Kidney J.2015;8(2):143–150. doi:10.1093/ckj/sfv008American Kidney Fund.Nephrotic syndrome treatments, causes & symptoms.National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in children.National Health Service (UK).Nephrotic syndrome in children.University of California San Francisco.06. Nephrotic syndrome.Jeele MOO, Adan AM.Nephrotic syndrome presented as a portal vein thrombosis: a case report.Ann Med Surg (Lond).2023;85(5):2112–2114. doi:10.1097/MS9.0000000000000482Kolb A, Gallacher PJ, Campbell J, et al.A national registry study of patient and renal survival in adult nephrotic syndrome.Kidney Int Rep. 2021:6(2):449-459. doi:10.1016/j.ekir.2020.10.033Lella G, Pecoraro L, Benetti E, et al.Nutritional management of idiopathic nephrotic syndrome in pediatric age.Med Sci (Basel).2023;11(3):47. doi:10.3390/medsci11030047Uwaezuoke SN.Steroid-sensitive nephrotic syndrome in children: triggers of relapse and evolving hypotheses on pathogenesis.Ital J Pediatr.2015;41:19. doi:10.1186/s13052-015-0123-9Lionaki S, Mantios E, Tsoumbou I, et al.Clinical characteristics and outcomes of adults with nephrotic syndrome due to minimal change disease.J Clin Med.2021;10(16):3632. doi:10.3390/jcm10163632
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in adults.Verma PR, Patil P.Nephrotic syndrome: a review.Cureus.2024;16(2):e53923. doi:10.7759/cureus.53923Busuioc RM, Mircescu G.Nephrotic syndrome complications – new and old. Part 1.Maedica (Bucur).2022;17(1):153–168. doi:10.26574/maedica.2022.17.1.153MedlinePlus.Acute nephritic syndrome.Kodner C.Diagnosis and management of nephrotic syndrome in adults.Am Fam Physician.2016;93(6):479-485.Nishi S, Ubara Y, Utsunomiya Y, et al.Evidence-based clinical practice guidelines for nephrotic syndrome 2014.Clin Exp Nephrol.2016;20:342–370. doi:10.1007/s10157-015-1216-xMedlinePlus.Minimal change disease.Zhang C, Leng L, Zhang X, Zhao Y, Li Z.Comprehensive identification of immune-associated biomarkers based on network and mRNA expression patterns in membranous glomerulonephritis.J Transl Med.2018;16:210. doi:10.1186/s12967-018-1586-4Greenhall GHB, Salama AD.What is new in the management of rapidly progressive glomerulonephritis?Clin Kidney J.2015;8(2):143–150. doi:10.1093/ckj/sfv008American Kidney Fund.Nephrotic syndrome treatments, causes & symptoms.National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in children.National Health Service (UK).Nephrotic syndrome in children.University of California San Francisco.06. Nephrotic syndrome.Jeele MOO, Adan AM.Nephrotic syndrome presented as a portal vein thrombosis: a case report.Ann Med Surg (Lond).2023;85(5):2112–2114. doi:10.1097/MS9.0000000000000482Kolb A, Gallacher PJ, Campbell J, et al.A national registry study of patient and renal survival in adult nephrotic syndrome.Kidney Int Rep. 2021:6(2):449-459. doi:10.1016/j.ekir.2020.10.033Lella G, Pecoraro L, Benetti E, et al.Nutritional management of idiopathic nephrotic syndrome in pediatric age.Med Sci (Basel).2023;11(3):47. doi:10.3390/medsci11030047Uwaezuoke SN.Steroid-sensitive nephrotic syndrome in children: triggers of relapse and evolving hypotheses on pathogenesis.Ital J Pediatr.2015;41:19. doi:10.1186/s13052-015-0123-9Lionaki S, Mantios E, Tsoumbou I, et al.Clinical characteristics and outcomes of adults with nephrotic syndrome due to minimal change disease.J Clin Med.2021;10(16):3632. doi:10.3390/jcm10163632
National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in adults.
Verma PR, Patil P.Nephrotic syndrome: a review.Cureus.2024;16(2):e53923. doi:10.7759/cureus.53923
Busuioc RM, Mircescu G.Nephrotic syndrome complications – new and old. Part 1.Maedica (Bucur).2022;17(1):153–168. doi:10.26574/maedica.2022.17.1.153
MedlinePlus.Acute nephritic syndrome.
Kodner C.Diagnosis and management of nephrotic syndrome in adults.Am Fam Physician.2016;93(6):479-485.
Nishi S, Ubara Y, Utsunomiya Y, et al.Evidence-based clinical practice guidelines for nephrotic syndrome 2014.Clin Exp Nephrol.2016;20:342–370. doi:10.1007/s10157-015-1216-x
MedlinePlus.Minimal change disease.
Zhang C, Leng L, Zhang X, Zhao Y, Li Z.Comprehensive identification of immune-associated biomarkers based on network and mRNA expression patterns in membranous glomerulonephritis.J Transl Med.2018;16:210. doi:10.1186/s12967-018-1586-4
Greenhall GHB, Salama AD.What is new in the management of rapidly progressive glomerulonephritis?Clin Kidney J.2015;8(2):143–150. doi:10.1093/ckj/sfv008
American Kidney Fund.Nephrotic syndrome treatments, causes & symptoms.
National Institute of Diabetes and Digestive and Kidney Diseases.Nephrotic syndrome in children.
National Health Service (UK).Nephrotic syndrome in children.
University of California San Francisco.06. Nephrotic syndrome.
Jeele MOO, Adan AM.Nephrotic syndrome presented as a portal vein thrombosis: a case report.Ann Med Surg (Lond).2023;85(5):2112–2114. doi:10.1097/MS9.0000000000000482
Kolb A, Gallacher PJ, Campbell J, et al.A national registry study of patient and renal survival in adult nephrotic syndrome.Kidney Int Rep. 2021:6(2):449-459. doi:10.1016/j.ekir.2020.10.033
Lella G, Pecoraro L, Benetti E, et al.Nutritional management of idiopathic nephrotic syndrome in pediatric age.Med Sci (Basel).2023;11(3):47. doi:10.3390/medsci11030047
Uwaezuoke SN.Steroid-sensitive nephrotic syndrome in children: triggers of relapse and evolving hypotheses on pathogenesis.Ital J Pediatr.2015;41:19. doi:10.1186/s13052-015-0123-9
Lionaki S, Mantios E, Tsoumbou I, et al.Clinical characteristics and outcomes of adults with nephrotic syndrome due to minimal change disease.J Clin Med.2021;10(16):3632. doi:10.3390/jcm10163632
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