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
  • Sudden weight gain

Anatomy of the Kidney

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

The most common cause in children is minimal change disease. Other kidney diseases can also cause this syndrome.

Causes from other health problems can also harm the kidneys. This may be from an infection or a blood disorder.

Certain genes that run in families can also cause nephrotic syndrome.

Risk Factors

Your child's chances are higher if they:


If your child has 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
  • A feeling of sickness
  • Pale skin
  • Mood changes
  • Lack of hunger
  • Foamy urine
  • Fatigue


The doctor will ask about your child’s symptoms and health history. They may also have:

  • A physical exam—the doctor may notice fluid buildup
  • 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
  • A kidney biopsy

Your child may be referred to a specialist for care.


In most children, nephrotic syndrome goes away on its own without long term harm. If your child has a health condition that is causing these problems, it will need to be treated.

In some children, the first time they need care, it may be in a hospital. Care may involve IV medicines.

Your child may have times when the syndrome does not cause problems. There may be other times when there is a relapse and symptoms are more active.

Care may involve:

Changes in Diet

Certain changes to the diet will help ease problems such as swelling. You may have to limit salt, fats, cholesterol, and fluids in your child’s diet.


Care may involve medicines to manage:

  • The effects of the immune system and improve kidney function—corticosteroids
  • Fluid buildup—diuretics
  • High blood pressure
  • The amount of protein in the urine

If your child’s medicines are causing harm to the kidneys, their doctor will change them.


There are no steps to prevent nephrotic syndrome.


Kids Health—Nemours Foundation

National Institute of Diabetes and Digestive and Kidney Disorders


Caring for Kids—Canadian Paediatric Society

The Kidney Foundation of Canada


Childhood nephrotic syndrome. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: Updated September 2014. Accessed June 7, 2018.

Childhood nephrotic syndrome. National Kidney Foundation website. Available at: Accessed June 7, 2018.

Nephrotic syndrome. Kids Health—Nemours Foundation website. Available at: Updated March 2014. Accessed June 7, 2018.

Nephrotic syndrome in children. Children’s Hospital of Philadelphia website. Available at: Accessed June 7, 2018.

Nephrotic syndrome in children. EBSCO DynaMed Plus website. Available at: Updated December 8, 2017. Accessed June 7, 2018.

Last reviewed May 2018 by EBSCO Medical Review Board Adrienne Carmack, MD  Last Updated: 6/7/2018