Nephrotic Syndrome is a kidney disorder characterized by a group of symptoms that occur when the filtering units of the kidneys, known as glomeruli, become damaged. These glomeruli normally prevent essential proteins from leaking into the urine. However, when they are inflamed or injured, large amounts of protein pass into the urine (proteinuria), resulting in low levels of protein in the blood (hypoalbuminemia), swelling in various parts of the body (edema), and increased blood cholesterol levels. Nephrotic Syndrome can occur at any age, but it is most commonly seen in children, especially between the ages of 2 and 6 years.
The main features of Nephrotic Syndrome include heavy proteinuria, generalized edema, and reduced blood albumin levels. Edema may first appear around the eyes, particularly in the morning, and can later involve the feet, abdomen, and entire body. As the kidneys lose protein, the liver compensates by increasing cholesterol production, leading to hyperlipidemia. This combination of symptoms can significantly impact a child's health and daily activities.
Nephrotic Syndrome can be caused by various underlying conditions. In children, the most common form is Minimal Change Disease (MCD), which typically responds well to steroid treatment. Other causes include focal segmental glomerulosclerosis (FSGS), membranous nephropathy, infections, genetic defects, and autoimmune diseases such as lupus. In many cases, the exact cause is unknown. Diagnosis is made through clinical evaluation, urine tests showing high protein levels, blood tests indicating low albumin and high cholesterol, and sometimes a kidney biopsy.
Treatment focuses on managing symptoms, preventing complications, and addressing the underlying cause. Corticosteroids are the first line of treatment in most children with MCD and often lead to complete remission. Additional medications such as diuretics, albumin infusions, ACE inhibitors, or immunosuppressants may be required depending on the severity and response to therapy. Dietary modifications, including reducing salt intake and maintaining adequate protein, are also important.
Although many children outgrow the condition or experience long periods of remission, some may have frequent relapses. Close monitoring by a pediatrician or pediatric nephrologist is essential. Early diagnosis and proper management significantly reduce complications such as infections, blood clots, malnutrition, and kidney damage. With timely care, most children with Nephrotic Syndrome can lead healthy and active lives.
