Nephrotic Syndrome—Adult

Pronounced: Neh-frah-tik sin-drome


Nephrotic syndrome is a group of changes affecting the kidneys. These may involve:

  • 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

Copyright © Nucleus Medical Media, Inc.


Tiny tubules inside the kidneys filter wastes from blood and make urine. If they aren’t working well, wastes and fluids build up in the body.

Causes are from kidney related health problems such as:

Causes from other health problems that harm the kidneys such as:

Risk Factors

Your risk is higher if you have:

  • Diabetes
  • Autoimmune diseases such as SLE
  • Used certain medicines for a long time
  • Contact with toxins
  • Certain infections such as HIV
  • Cancer
  • Health problems that slow blood flow


If you have problems, you may notice:

  • Swelling of feet, ankles, and legs—less often belly, hands, and face
  • Weight gain—caused by too much fluid in the body
  • Breathing problems—caused by too much fluid in the lungs
  • Lack of hunger
  • Foamy urine
  • Fatigue


The doctor will ask about your symptoms and health history. Your answers and a physical exam may point to nephrotic syndrome. You may also have:

  • Urine tests to look for blood, certain proteins, or other markers
  • Blood tests to look for certain proteins or other markers, or count blood cells
  • Imaging tests:
  • A kidney biopsy

You will be referred to a specialist for care.


Care depends on the cause. In some people, nephrotic syndrome goes away on its own.

If needed, care focuses on keeping the kidneys working and lowering the chances of further injury. It may involve:

  • Changes in diet to watch protein, cholesterol, and salt intake
  • Medicines to watch high blood pressure, ease fluid buildup, or lower the amount of protein in the urine
  • Dialysis —a machine works for your kidneys by filtering your blood


There are no steps to prevent nephrotic syndrome. To lower your chances of kidney problems:

  • Follow your care plan if you have health problems that cause harm to the kidneys.
  • Seek care for infections that linger.


National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney Foundation


The Kidney Foundation of Canada


Nephrotic syndrome. National Kidney Foundation website. Available at: Accessed June 7, 2018.
Nephrotic syndrome in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated March 21, 2016. Accessed June 7, 2018.
Nephrotic syndrome in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: Updated February 2014. Accessed June 7, 2018.
Overview of nephrotic syndrome. Merck Manual Professional Version website. Available at: Updated January 2018. Accessed June 7, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/7/2018

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