Nephrotic Syndrome - Treatment in India
Nephrotic syndrome is a disorder caused by damage to the small blood vessels in your kidneys that filter waste and excess water from your blood. When healthy, these small blood vessels keep blood protein from seeping into your urine and out of your body. When damaged, they don't perform this function effectively, and protein can leak out of your blood and lead to swelling (edema).
Treatment for nephrotic syndrome includes treating the underlying condition that's causing it and taking medications. Nephrotic syndrome can increase your risk of infections and blood clots. Your doctor may recommend steps to prevent these and other complications of nephrotic syndrome.
Symptoms of Nephrotic Syndrome
Signs and Symptoms of Nephrotic Syndrome include : -
- Swelling (edema), particularly around your eyes and in your ankles and feet
- Foam in the toilet water, which may be caused by excess protein in your urine
- Weight gain due to excess fluid retention
- Loss of appetite
Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.
The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.
This condition can also occur as a result of infection (such as strep throat, hepatitis, or mononucleosis), use of certain drugs, cancer, genetic disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis.
It can accompany kidney disorders such as glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.
Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. This disorder occurs slightly more often in males than females.
Exams and Tests
The doctor will perform a physical exam. Laboratory tests will be done to see how well the kidneys are working.
- Creatine - blood test
- Blood urea nitrogen (BUN)
- Creatinine clearance
- Albumin blood test - may be low
- Urinalysis - reveals large amounts of urine protein
Fats are often also present in the urine. Blood cholesterol and triglyceride levels may increase.
A Filtering Role
The glomeruli filter your blood as it passes through your kidneys. After being filtered by the glomeruli, blood travels through veins in your kidneys back to your bloodstream. The filtered substances, after being modified by the tubules, go through a tube from each kidney (ureter) to your bladder and pass out of your body when you urinate.
Every day about 2 quarts of water, along with waste products and electrolytes, leave your body as urine. When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body, a condition known as kidney failure.
The goals of treatment are to relieve symptoms, prevent complications and delay progressive kidney damage. Treatment of the disorder that causes the condition is necessary to control nephrotic syndrome. Treatment may be needed for life.
Controlling blood pressure is the most important measure to delay kidney damage. The goal is to keep blood pressure at or below 130/80 mmHg. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used in this case. ACE inhibitors may also help decrease the amount of protein loss in the urine.
Corticosteroids and other drugs that suppress or quiet the immune system may be used. High cholesterol and levels should be treated to reduce the risk of heart and blood vessel problems. However, a low-fat, low-cholesterol diet is usually not as helpful for people with nephrotic syndrome. Medications to reduce cholesterol and triglycerides may be needed, most commonly statins.
A low salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem.
Low protein diets may or may not be helpful. A moderate-protein diet (1 gram of protein per kilogram of body weight per day) may be suggested.
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