Definition

Nephrotic syndrome is a disorder of the kidneys. It may result in:

• High amounts of protein in the urine
• High cholesterol in the blood
• Swelling in the body—mainly in the feet and legs
• Low levels of a certain protein in the blood

Anatomy of the Kidney

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Causes

Tiny filters in the kidneys remove waste from the blood and makes urine. If they are not working well, wastes and fluids build up in the body.

The most common cause is damage from kidney problems such as:

• Focal segmental glomerulosclerosis
• Membranous nephropathy
• Glomerulonephritis
• IgA nephropathy
• Minimal change disease

Other causes are problems that harm the kidneys such as:

• Diabetic nephropathy
• Buildup of certain proteins—amyloidosis
• Systemic lupus erythematosus
• Certain infections such as HIV
• Sickle cell disease
• Some cancers

Risk Factors

The risk of this problem is higher in people who have:

• Any of the health problems that cause the condition
• Used certain medicines for a long time
• Contact with certain toxins
• Health problems that slow blood flow

Symptoms

Symptoms may be:

• Swelling of feet, ankles, and legs—less often belly, hands, and face
• Feeling tired
• Not feeling hungry
• Weight gain
• Foamy urine
• Breathing problems

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood and urine tests will be done to check kidney function. Results can make the diagnosis.

Other tests will be done to look for a cause. You may need to see a doctor who treats kidney diseases.

Treatment

In some people, nephrotic syndrome goes away on its own. In others, the cause will need to be treated. Options are:

• Diet changes
• Medicines to lower:
  • High blood pressure
  • High cholesterol
  • Fluid buildup
  • Protein in the urine
• Dialysis to filter blood when the kidneys cannot

Prevention

The risk may be lowered by managing health problems that can harm the kidneys.