Nephrotic syndrome is a problem where too much protein called albumin is released from the body into the urine. It means that one or both kidneys are damaged.
The kidneys contain many coils of tiny blood vessels. Each of these is called a glomerulus. Glomeruli filter substances from the blood into the urine. Nephrotic syndrome occurs when the glomeruli stop working normally.
A child with nephrotic syndrome may have:
The most common type is called minimal change nephrotic syndrome (MCNS). With MCNS, a child has times when symptoms get worse (relapses). But the condition can be managed over time. In rare cases, a child may develop kidney failure and need dialysis.
Most children with this problem have idiopathic nephrotic syndrome. Idiopathic means that it occurs with no known cause.
In rare cases, a rare nephrotic syndrome may occur in the first week of life. This is called congenital nephrotic syndrome. It is inherited by an autosomal recessive gene. This means that boys and girls are equally affected. A child inherits 1 copy of the gene from each parent, who are carriers. Carrier parents have a 1 in 4 chance of having a child with this syndrome with each pregnancy. The outcome for this type of nephrotic syndrome is very poor.
Symptoms can occur a bit differently in each child. They can include:
The symptoms of nephrotic syndrome can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have tests, such as:
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
During the first episode of nephrotic syndrome, your child may need to stay in the hospital. Your child may need to be watched if the swelling is severe or if he or she has blood pressure or breathing problems.
Medicines may be used to treat initial symptoms and relapses. These may include:
The medicines used to treat nephrotic syndrome weaken the immune system. Because of this, your child should not be given live vaccines. If your child has not had the chickenpox vaccine and is exposed to the virus, he or she may need a vaccine.
Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines.
Children with nephrotic syndrome may have trouble regulating their body's water balance. This can cause swelling from fluid retention (edema). The diet for a child with nephrotic syndrome may include limiting salt and fluids. This may help to regulate your child's fluid balance. Fluids include any food that is liquid at room temperature, such as popsicles and ice cream. Salt affects body swelling. Don't add salt at the table and don't give your child salty foods. Your child's healthcare provider will talk with you how much salt and fluids your child should have each day.
In rare cases, a child may develop kidney failure and need dialysis. Dialysis is a procedure that filters waste and extra fluid from the blood. This is normally be done by the kidneys.
You can help your child stay healthy in these ways:
You can get more resources and support from these organizations:
Nephrotic syndrome can get better on its own and with treatment. It may also get worse despite treatment. A child may have periods of improvement and relapses. Family support is important for a child’s well-being.
Once a child reaches the teen years, the syndrome usually stays in remission. This means that symptoms decrease or go away. In most cases, symptoms don’t return in adulthood.
Call your child’s healthcare provider if your child has:
Call 911 if your child has:
Tips to help you get the most from a visit to your child’s healthcare provider:
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