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Nephrotic Syndrome

Nephrotic Syndrome - What it is

Nephrotic syndrome is a syndrome comprising the following:

  • Edema -  swelling of the face, legs, or ankles due to the abnormal collection of fluids in
    the tissues that is usually accompanied by rapid weight gain
  • Proteinuria - large amount of protein contained in urine (more than 3 to 3.5g/day) that
    can be identified by frothy or foamy urine in the toilet bowl.
  • Hypoalbumina - low level of albumin (less than 30g/L) in the blood

Find out more about nephrotic syndrome:

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Nephrotic Syndrome - Symptoms

Nephrotic Syndrome - How to prevent?

Nephrotic Syndrome - Causes and Risk Factors

​Nephrotic syndrome can be primary, meaning damage is confined to the kidneys alone,
or it can be secondary, meaning organs other than the kidney are also affected.

Primary causes

  • Minimal change disease (MCD) is a kidney disease that can occur in both adults and
    children The disease gets its name because the damage to the glomeruli cannot be
    seen under a regular microscope and can only be seen under a powerful microscope
    called an electron microscope

  • Focal segmental glomerulosclerosis (FSGS) is the most common cause of nephrotic
    syndrome in adults. FSGS can cause collapse and scarring of some glomeruli
    Membranous nephropathy (MN) is a condition in which the walls of the glomerular
    blood vessels become thickened

Secondary causes

  • Diabetes mellitus causing diabetic kidney disease is common in patients with diabetes
    who have chronically elevated blood glucose levels and/or high blood pressure
    Patients with more advanced disease can develop the nephrotic syndrome

  • Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple
    organs of the body, including the kidney, causing nephrotic syndrome

Nephrotic Syndrome - Diagnosis

  • Urine tests to determine the amount of protein in the urine
  • Blood tests to assess kidney function, look for auto-antibodies, and other associated conditions such as viral infections
  • Imaging of the kidneys and other organs if necessary
  • Kidney biopsy is a procedure done under local anesthesia and guided by ultrasound to obtain a small sample of kidney tissue for microscopic examination

Find out more about the kidney biopsy through this link  https://youtu.be/maZtXG-NtV0

 

Nephrotic Syndrome - Treatments

​General treatment of the symptoms of nephrotic syndrome

  • Diuretics to help get rid of excess water and salt
  • Dietary salt restriction
  • Medications such as ACE inhibitors or angiotension receptor blockers (ARB) to lower blood pressure, prevent worsening of kidney disease, and reduce the amount of protein excreted in the urine.
  • Anticoagulation therapy (Blood thinners) to prevent blood clots if the protein leak is significant.

Acute Treatment

  • Immunosuppressant: medication that alter the body’s immune system to reduce the damage to the kidney cells. These medications often have side effects.
  • Renal replacement therapy in the form of dialysis may be required if the kidney function is severely impaired.

Treating the underlying disease

  • Minimal change disease (MCD) almost always responds initially to treatment with
    glucocorticoids (steroids). However, relapses are common, and additional treatment
    with other immunosuppressants may be required to maintain remission.
  • Focal segmental glomerulosclerosis (FSGS) can be classified as primary FSGS or
    Secondary FSGS The treatment of primary FSGS is similar to MCD Secondary FSGS is
    treated primarily with ACE inhibitors or ARBs.
  • Membranous nephropathy (MN) for patients with mild symptoms, a period of
    “watch and wait” is recommended initially to determine if the condition is worsening
    or causing complications Immunosuppressive treatment is generally held off for a
    period of about 6 months until/unless symptoms worsen However if the patient has
    severe symptoms from the start or if the condition progresses while under monitoring,
    treatment should be started.
  • Diabetes mellitus  - Management includes intensive management of blood sugar
    levels, cholesterol, and blood pressure.
  • Lupus -Patients with lupus who have nephrotic syndrome or evidence of worsening
    kidney function can be treated with steroids and immunosuppressants.

Nephrotic Syndrome - Preparing for surgery

Nephrotic Syndrome - Post-surgery care

Nephrotic Syndrome - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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