Mary Bridge Children's Hospital

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Nephrology & Hypertension

Nephrotic Syndrome

What Is It?

The kidneys normally work like a filter to keep proteins in the blood while waste products get filtered out. When the kidneys do not work properly, the protein leaks out of the blood and into the urine. When a lot of protein leaks out into the urine, it may change how a person looks and affect the results of their blood tests. This is considered nephrotic syndrome.

 Nephrotic Syndrome: "Important Information to Know” (PDF)

Children may have:

  • Swelling of the body (edema) - often times around the eyes, in the belly, or in the legs and feet
  • Less urine than usual
  • Low levels of protein in the blood
  • Increased blood pressures
  • High levels of cholesterol in the blood

Learn more about how the kidneys act like a coffee filter.

Causes

Causes

There are diseases of the kidney that cause Nephrotic Syndrome, such as:

  • Minimal Change Disease - most common
  • Focal Segmental Glomerulosclerosis (FSGS)
  • Membranous Nephropathy

There is nothing you did as a parent that caused your child to have kidney problems. In fact, these disease are called “idiopathic,” as we do not know why they occur. Nephrotic syndrome may also occur as a result of other medical problems, such as diabetes, cancer, lupus, infection, drugs, allergies and vasculitis.

Diagnosis

Your doctor will order urine and blood tests. Your doctor will also ask questions about your child’s symptoms and do a physical exam.
Procedures

Your doctor may order a renal ultrasound to look at the kidneys.

If your child does not get better while taking prednisone(PDF), your child may need a kidney biopsy. During a kidney biopsy, a tiny piece of tissue is removed from the kidney. A doctor will look at the tissue under a microscope. If your child needs a kidney biopsy, they will be sent to Seattle Children's Hospital for treatment and care.

To learn more information about kidney biopsies, click on the following:


Treatments

Treatment will always involve:

  • Checking your child’s urine for protein at home.  The nursing staff will teach you how to dip your child’s urine for protein.  It is easy to do. Always make sure you have the right type of urine sticks (urine sticks should test for protein, not glucose or ketones).
    Also make sure your sticks are not expired.

  • Eating a healthy and low salt diet. Here are resources to obtain these goals:

 - Low Salt Eating Guidelines(PDF)
 - Low and High Sodium at the Grocery Store(PDF)
 - Reading labels, choosing low salt foods and eating at restaurants
 - Nutritional information about store and restaurant foods
- Visit Lowsaltfoods.com - a useful website with information on reading labels, choosing low salt foods, and eating at restaurants.

 
  • Avoiding exposure to people with chickenpox or other illnesses

  • Avoiding second hand smoke

  • Good hand washing to prevent infection. We encourage all families to watch the following on-line video on hand washing from the Center for Disease Control and Prevention (CDC): "Put Your Hands Together" 



    Treatment may also involve:

    • Taking Prednisone(PDF), an immunosuppression medication. Prednisone(PDF) helps decrease the inflammation of the kidneys.  As a result, the kidneys will leak less protein.
    • Taking a diuretic medication to decrease fluid in the body
    • Taking a blood pressure medication to help lower blood pressure
    • An albumin infusion to decrease swelling and puffiness
    • Medications to lower cholesterol
    • Medications to lower blood pressure