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Nephrotic syndrome is a group of symptoms that, together, show that your kidneys are not working as well as they should. The symptoms of nephrotic syndrome include:

  • Too much protein in your urine (proteinuria)
  • Low levels of protein in your blood (hypoalbuminia)
  • High levels of fat and cholesterol in your blood
  • Swelling in your legs, feet, ankles, or hands (edema)

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Who is at risk for nephrotic syndrome?

Anyone can get nephrotic syndrome but it is slightly more common in men than in women. In children, it happens most often between the ages of 2 and 6. There are other factors that may increase your risk.
You are more likely to get nephrotic syndrome if you:

  • Have a disease that affects the kidneys such as FSGS, lupus, or diabetes
  • Take certain medicines like nonsteroidal anti-inflammatory drugs (NSAIDS) or antibiotics
  • Have an infection such as HIV, hepatitis B and C, or malaria

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What are the symptoms of nephrotic syndrome?

You may not know that you have nephrotic syndrome until you have routine blood and urine tests at a doctor’s appointment. The results of your tests can show that you have too much protein in your urine, not enough protein in your blood, or too much fat or cholesterol in your blood.

Signs of nephrotic syndrome that you may notice are:

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What causes nephrotic syndrome?

Nephrotic syndrome happens when there is a problem with your kidneys’ filters. When your kidneys’ filters are not working in the right way, this can lead to the symptoms of nephrotic syndrome.

This damage to the kidneys’ filters is caused by diseases that damage the kidneys. Some of these diseases affect only the kidneys, and these are called primary causes of nephrotic syndrome. Other diseases affect the whole body, including the kidneys, and these are called secondary causes of nephrotic syndrome. Most people who have nephrotic syndrome have secondary causes.

The most common primary cause of nephrotic syndrome in adults is a disease called focal segmental glomerulosclerosis (FSGS). The most common secondary cause of nephrotic syndrome in adults is diabetes.

In children, the most common primary cause of nephrotic syndrome is minimal change disease. The most common secondary cause of nephrotic syndrome in children is diabetes.

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Focal segmental glomerulosclerosis (FSGS)

FSGS is the leading kidney disease that causes nephrotic syndrome. For more information on FSGS, click here.

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What are the complications of nephrotic syndrome?

When you have nephrotic syndrome, you lose protein through your urine. Proteins do many jobs in your body, and everyone needs protein to live. Your body uses protein to build bones, muscles, and other tissues, and fight infections.

When you have nephrotic syndrome, your kidneys may let a protein called albumin escape through your kidneys’ filters into your urine. Albumin helps your body get rid of extra fluid. When you do not have enough albumin in your blood, fluid can build up in your body, causing swelling in your legs, feet and ankles. You can also start to have other problems, such as blood clots and infections.

With nephrotic syndrome, your body may not get rid of cholesterol in the right way, allowing it to build up in your blood. When you have too much cholesterol in your blood, it can stick together and form clumps inside your veins and arteries. This makes it harder for your heart to pump your blood, and can cause a heart attack or a stroke.

Other complications that can be caused by nephrotic syndrome include:

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What is the treatment for nephrotic syndrome?

There is no cure for nephrotic syndrome, but there are treatments that can help you manage symptoms and prevent more kidney damage. If your kidneys stop working, you will need dialysis or a kidney transplant to live.

Your health care provider might tell you to take certain medicines to treat the symptoms of nephrotic syndrome.

  • Medicines to control blood pressure and cholesterol can help reduce your chances of having heart disease.
  • Medicine to help your body get rid of extra water can help control your blood pressure and can reduce swelling.
  • Medicines to prevent blood clots can help prevent heart attack and stroke.

Changing your diet may also help you manage your symptoms. Choosing fish or low-fat cuts of meat instead of higher fat options can help keep your cholesterol under control. Limiting how much salt (sodium) you take in can help prevent swelling and help keep your blood pressure at a healthy level.

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How can I prevent nephrotic syndrome?

The only way to prevent nephrotic syndrome is to control the disease that caused it. If you have a disease that can damage your kidneys, work with your health care provider to prevent further kidney damage. If you take prescription medicines, take all of your doses exactly as you are told.

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Diet for nephrotic syndrome

When you have nephrotic syndrome, a dietitian may recommend you make changes to the amount of protein, salt, and fat that you eat.

Protein

The amount of protein you should eat depends on your kidney health. For some people with nephrotic syndrome, eating a diet with a low to moderate amount of protein is best. Talk to a dietitian about how much protein you should eat.

Salt

Limiting how much salt (sodium) you take in can help prevent swelling and keep your blood pressure at a healthy level.

Fat

Eating a diet low in saturated fat and cholesterol can help prevent high cholesterol associated with nephrotic syndrome.

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More information on nephrotic syndrome

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has information about nephrotic syndrome in adults and nephrotic syndrome in children.

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