Childhood Nephrotic Syndrome

Nephrotic syndrome is a condition in which your kidneys “leak” protein from your blood into your urine.  In children, nephrotic syndrome may only be temporary, or it may be an early sign of kidney damage.

Learn about Nephrotic Syndrome in Adults

What is nephrotic syndrome?

Healthy kidneys filter waste and extra fluid from your blood.  Your body gets rid of the waste and extra fluid as urine.  In nephrotic syndrome, some protein, which normally stays in your blood, gets removed along with the waste.  This is a problem, because your body needs protein.

Protein acts like a sponge in your blood.  It holds fluid that your body needs inside your arteries and veins.  If there is not enough protein, the fluid can leak into other tissues in your body.  This can cause edema (swelling).  This usually happens around your eyes, face, belly, ankles and feet.

Are there different types of nephrotic syndrome?

Yes.  The most common type of nephrotic syndrome in children is called minimal change disease.  With minimal change disease, there are very tiny physical changes in the tiny filters (called glomeruli) in the kidneys.  These tiny changes can affect how the kidneys work.

Minimal change disease can usually be treated with a medicine called prednisone, but this type of nephrotic syndrome can come back.  This 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. 

How can I keep my child from getting nephrotic syndrome?

We do not know what causes nephrotic syndrome in children, so we cannot prevent it.

What are the symptoms?

If your child has nephrotic syndrome, you may notice swelling around his or her eyes, face, ankles or feet. 

How will I know if my child has nephrotic syndrome?

Your child’s doctor may need to do a few tests to find out if your child has nephrotic syndrome.

• Urine test:  The doctor may test a sample of your child’s urine for protein.  If the first test shows a high level of protein, the doctor may want to test the urine again.  You may also 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 for how to get and check the urine sample.
• Blood test:  The doctor may also suggest a blood test to look at the levels of electrolytes, protein, creatinine and blood urea nitrogen (BUN) in your child’s blood.  These tests can help the doctor learn whether your child has nephrotic syndrome or whether there is another cause for the protein in his or her urine.
• In some cases, your child’s doctor may suggest a kidney biopsy.  This means that a tiny piece of your child’s kidney will be removed and viewed under a microscope.  A kidney biopsy can usually be done with a needle and does not require surgery.  The kidney biopsy can help show what type of nephrotic syndrome your child has and whether there are any other problems that need to be treated. 

Is there a cure for nephrotic syndrome?

There is no cure for nephrotic syndrome, but many children grow out of the disease. 

What are the treatments for nephrotic syndrome?

The type of treatment your child will need depends on the type of nephrotic syndrome he or she has.  For minimal change disease, the most common treatment is prednisone, a type of steroid.  Prednisone helps to keep protein from leaking into your child’s urine.  If prednisone does not work, or if its side effects are too much, your child’s doctor may prescribe other medicines.

Other treatments may 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 can help keep fluid from building up, too.  In extreme cases, albumin (a kind of protein), given through an IV can help replace some of the protein in your child’s blood.

If your child’s doctor finds any other problems while testing, those may need to be treated too.