Childhood Nephrotic Syndrome

Kidney Disease

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Nephrotic syndrome is a condition that causes the kidneys to “leak” protein from the blood to the urine. In children, nephrotic syndrome may only be temporary, or it may be the first sign of kidney damage.

What is nephrotic syndrome?
Are there different types of nephrotic syndrome?
How can I keep my child from getting nephrotic syndrome?
What are the symptoms?
How will I know if my child has nephrotic syndrome?
Is there a cure for nephrotic syndrome?
What are the treatments?
More Information

Learn about Nephrotic Syndrome in Adults

What is nephrotic syndrome?

Healthy kidneys filter waste and extra fluid from blood. The body gets rid of these wastes and fluid through urine. In nephrotic syndrome, some protein gets removed along with the wastes. This is a problem, because the body needs protein.

Protein acts as a sponge in the blood. It holds fluids that the body needs inside arteries and veins. If there is not enough protein, this fluid leaks out into other body tissues. The result is edema, or swelling. This usually happens around the eyes, face, feet, ankles and abdomen.

Are there different types of nephrotic syndrome?

Yes. The most common type of nephrotic syndrome in children is called minimal change disease. This means that there are very few physical changes in the glomeruli (filters) of the kidneys. It can usually be treated with a medicine called prednisone, but it may come back. This is called a “relapse”. Most children will grow out of minimal change disease in their teen years.

Other types of nephrotic syndrome can be harder to treat and may cause more serious long term problems. Often, a blood test or biopsy is needed to diagnose these types of nephrotic syndrome.

How can I keep my child from getting nephrotic syndrome?

Because we do not know what causes nephrotic syndrome, we cannot prevent it. In other words, there is nothing you can do to keep your child from getting nephrotic syndrome.

What are the symptoms?

Swelling around the eyes, face, feet and ankles.
A basic urine test will have a high protein level.
A blood test will show a low level of protein.

How will I know if my child has nephrotic syndrome?

Your child’s doctor will need to do a couple of tests to find out if your child has nephrotic syndrome.

First, the doctor will test a sample of your child’s urine for protein. If this test shows a high protein level, the doctor will want to test the urine again. You may be asked to check your child’s urine for protein over a couple of days at home. In this case, your child’s doctor will give you directions on how to get and check the urine sample.

If your child’s urine still shows a high protein level, the next step is a blood test. The doctor will draw some of your child’s blood to test it for several chemicals. These include electrolytes, protein, creatinine and BUN (blood urea nitrogen). These tests can help tell if your child has nephrotic syndrome or suggest another cause for the protein in your child’s urine.

In some cases, your child’s doctor may suggest a kidney biopsy. This means that a tiny piece of the kidney will be removed and viewed under a microscope. Usually, this can be done with a needle and does not require surgery. A kidney biopsy can show what type of nephrotic syndrome your child has and if there are any other problems.

Is there a cure for nephrotic syndrome?

There is no cure for nephrotic syndrome, but many children grow out of the disease. Treating its symptoms and controlling protein loss are the only options.

What are the treatments?

Treatment depends on the type of nephrotic syndrome. For minimal change disease, prednisone, a type of steroid, is the most common treatment. This helps control or stop protein from leaking into the urine. If prednisone does not work or if its side effects are too much, other medicines may be used.

Other treatments can help control the swelling caused by nephrotic syndrome. A diuretic (“water pill”) can help to get rid of the extra fluid. Low-sodium (low-salt) diets will keep the fluid from building up, too. In extreme cases, albumin (protein), given through an IV, can help replace protein in the blood.

More Information

Nephrotic Syndrome

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/
nephrotic_syndrom/
PDF: Click Here

National Kidney Foundation
http://www.kidney.org/atoz/atozItem.cfm?id=53

NephCure Foundation
http://www.nephcure.org/

NephKids
http://cnserver0.nkf.med.ualberta.ca/NEPHKIDS/

FSGS - Brigham and Women's Hospital/Harvard Medical School

The Brigham and Women's Hospital/Harvard Medical School is running a research project on FSGS (focal segmental glomerular sclerosis) and other causes of nephrotic syndrome, kidney failure, and proteinuria at the Brigham and Women?s Hospital/Harvard Medical School in Boston, Massachusetts. Click here to learn more.

Click here to download the FSGS brochure.