Nephrotic Syndrome Treatment in Delhi, India

Nephrotic syndrome is a serious kidney disorder causing the body to excrete excessive protein in the urine. The small blood vessels in the kidneys that filter waste and excess water from the blood are damaged, thereby causing swelling in the feet and ankles.

Recognizing the early signs of nephrotic syndrome can offer several advantages, as these symptoms provide crucial insights into potential kidney dysfunction and the loss of essential proteins in the urine. Here are some of the most common signs and symptoms of Nephrotic Syndrome.

Weight Gain: Nephrotic syndrome often leads to significant fluid retention in the body, a condition known as edema. When the kidneys are not functioning properly, they may fail to effectively filter excess fluid from the bloodstream, resulting in the accumulation of fluid in various body tissues, particularly the legs, ankles, and face. This fluid buildup can lead to noticeable weight gain.

Fatigue: The loss of proteins, especially albumin, through the urine can lead to a decrease in the oncotic pressure in the blood vessels. This can cause fluid to leak out of blood vessels into the surrounding tissues, contributing to edema. As a result, the body may not receive an adequate supply of nutrients and oxygen, leading to fatigue and weakness.

Foamy Urine: One of the hallmark signs of nephrotic syndrome is the presence of foamy or frothy urine. This occurs because large amounts of protein, primarily albumin, are excreted in the urine. The presence of excess protein in the urine can create bubbles or foam when the urine is passed.

Loss of Appetite: Nephrotic syndrome can cause a general feeling of malaise and discomfort. The accumulation of fluid in the abdominal cavity can also lead to abdominal discomfort and reduced appetite. Additionally, the loss of essential proteins may contribute to a lack of appetite and weight loss over time.

Protein in Urine: Nephrotic syndrome is defined by the excessive loss of protein, specifically albumin, in the urine. Normally, the kidneys filter waste products from the blood while retaining essential proteins. In nephrotic syndrome, the damaged kidney filters allow these proteins to pass into the urine, leading to a condition called proteinuria.

The following factors can lead to an Increased risk of nephrotic syndrome.

Medical conditions

• Diabetes: Diabetes can damage the blood vessels in the kidneys, which can lead to proteinuria and nephrotic syndrome.
• Lupus: Lupus is an autoimmune disease that can cause inflammation in the kidneys, leading to proteinuria and nephrotic syndrome.
• Amyloidosis: Amyloidosis is a condition in which amyloid proteins build up in the body's tissues, including the kidneys. This can damage the kidneys and lead to nephrotic syndrome.
• Other kidney diseases: Other kidney diseases, such as glomerulonephritis and chronic kidney disease, can also increase the risk of nephrotic syndrome.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are a class of medications that are commonly used to treat pain and inflammation. However, NSAIDs can also damage the kidneys and increase the risk of nephrotic syndrome.

Infections

• Hepatitis B: Hepatitis B is a viral infection that can damage the liver and kidneys. This can lead to proteinuria and nephrotic syndrome.
• HIV: HIV is a virus that can attack the immune system. This can make the kidneys more vulnerable to infection and damage, leading to proteinuria and nephrotic syndrome.
• Hepatitis C: Hepatitis C is a viral infection that can damage the liver and kidneys. This can lead to proteinuria and nephrotic syndrome.
• Malaria: Malaria is a parasitic infection that can damage the kidneys. This can lead to proteinuria and nephrotic syndrome.

In addition to the risk factors listed above, there are a few other things that may increase the risk of nephrotic syndrome, such as:

• Family history: If you have a family history of nephrotic syndrome, you are more likely to develop it yourself.
• Race: African Americans and Hispanics are more likely to develop nephrotic syndrome than Caucasians.
• Age: Nephrotic syndrome can occur at any age, but it is most common in children and young adults.

Nephrotic syndrome can have various underlying causes. Here are some common causes and associated conditions:

• Minimal Change Disease: A primary kidney disorder that often occurs in children.
• Focal Segmental Glomerulosclerosis (FSGS): Scarring of the kidney's filtering units.
• Membranous Nephropathy: Thickening of the glomerular basement membrane.
• Diabetes: Diabetic nephropathy can lead to nephrotic syndrome.
• Lupus: Systemic lupus erythematosus can affect the kidneys.
• Infections: Some infections, like HIV and hepatitis, can lead to nephrotic syndrome.
• Medications: Certain drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics, can cause nephrotic syndrome in some cases.
• Genetic Factors: Inherited conditions can be a cause.
• Amyloidosis: Accumulation of abnormal proteins in the kidneys.
• Cancer: Some cancers, like lymphoma, can lead to nephrotic syndrome.
• Renal Vein Thrombosis: Blood clots in the renal veins can damage the kidneys.

It's important to note that nephrotic syndrome is a complex condition, and its cause can vary from person to person. Identifying the underlying cause is crucial for appropriate treatment and management.

Potential complications of nephrotic syndrome can lead to the following:

• Thrombosis: The impaired blood-filtering function of the glomeruli can result in the loss of essential blood proteins responsible for preventing blood clots. This elevates the risk of developing venous blood clots.
• Elevated Blood Lipids: A decrease in the protein albumin within the bloodstream prompts the liver to produce more albumin. Concurrently, the liver releases higher levels of cholesterol and triglycerides into the blood.
• Malnutrition: Excessive loss of blood proteins may lead to malnutrition. This can manifest as weight loss, which might be concealed by edema. Additionally, it can result in conditions such as anaemia, low blood protein levels, and vitamin D deficiency.
• Hypertension (High Blood Pressure): Damage to the glomeruli and the ensuing accumulation of excess bodily fluids can contribute to elevated blood pressure.
• Acute Kidney Injury: Should the glomeruli become too impaired to adequately filter blood, waste products may accumulate rapidly in the bloodstream. In such cases, emergency dialysis may be necessary, often performed with the aid of an artificial kidney machine (dialyzer).
• Chronic Kidney Disease: Nephrotic syndrome can cause a gradual decline in kidney function over time. In cases where kidney function diminishes significantly, dialysis or kidney transplantation may become necessary.
• Susceptibility to Infections: Individuals with nephrotic syndrome face an elevated risk of contracting infections due to compromised immune function.

Diagnosing nephrotic syndrome typically involves several tests and procedures. These may include:

• Urine Tests: A urinalysis is conducted to detect abnormalities in the urine, such as a significant presence of protein. Patients may be required to collect urine samples over a 24-hour period to assess protein levels.
• Blood Tests: Blood tests are performed to identify low levels of the protein albumin and often a decrease in overall blood protein levels. The loss of albumin is frequently associated with elevated blood cholesterol and triglyceride levels. Blood tests may also measure creatinine and urea nitrogen levels to evaluate overall kidney function.
• Kidney Biopsy: In some cases, a kidney biopsy may be recommended by the doctor. This procedure involves extracting a small sample of kidney tissue for laboratory testing. It involves inserting a needle through the skin into the kidney to collect kidney tissue.

The treatment for nephrotic syndrome involves treating any underlying medical condition that may be causing this syndrome. Depending upon the symptoms or complications, the doctor might recommend changes in diet or certain medications. Patients with nephrotic syndrome may also be given pneumococcal vaccines that help protect against a bacteria causing infection.

Here are some of the medications that a doctor might recommend:

• Blood pressure medications to control the amount of protein in the urine
• Water pills to control swelling by increasing the output of fluids in kidneys.
• Cholesterol reducing medicines to avoid heart attacks
• Blood thinners are also used for decreasing the blood's ability to clot
• Immune system suppressing medications to reduce the inflammation in the kidneys

How common is nephrotic syndrome?

Nephrotic syndrome is a relatively rare condition that affects less than 5 in 100.000 children and approx 1 in 30000 adults, every year.

Can nephrotic syndrome be cured?

It depends on the underlying cause. Some cases can be cured, while others may require long-term management.

What is the first line treatment for nephrotic syndrome?

The first-line treatment often involves medications like corticosteroids to reduce proteinuria and control symptoms.

Is nephrotic syndrome life-threatening?

In most cases, nephrotic syndrome is not life-threatening, but it can lead to severe complications if left untreated.

Who does nephrotic syndrome affect?

Nephrotic syndrome can affect people of all ages, including children and adults.

Should I avoid any foods or drinks if I have nephrotic syndrome?

Consult a nephrotic syndrome specialist for dietary recommendations based on your specific condition.

How can I prevent nephrotic syndrome?

It's not always preventable, but managing underlying conditions and following a healthy lifestyle can help reduce the risk.

What is the mainstay treatment of nephrotic syndrome?

The mainstay treatment often involves medications, such as corticosteroids, to manage symptoms and underlying causes.

What’s the difference between nephrotic syndrome and nephritic syndrome?

Nephrotic syndrome involves proteinuria and edema, while nephritic syndrome features hematuria and hypertension.

When should I see my healthcare provider?

If you experience symptoms like swelling, changes in urine, or unexplained weight gain, seek medical attention promptly.

What is congenital nephrotic syndrome?

Congenital nephrotic syndrome is a rare genetic form that affects infants and typically requires specialised care.

What is the main treatment of nephrotic syndrome in children?

Children with nephrotic syndrome are often treated with corticosteroids and other medications as prescribed by a paediatric nephrologist.

What are the side effects of the nephrotic syndrome treatment?

Side effects can vary depending on the medications used but may include weight gain, increased appetite, and immunosuppression.

Who is the best doctor for nephrotic syndrome at Max Hospital in Delhi NCR?

At Max Hospital in Delhi NCR, we are proud to have a team of some of the best nephrotic syndrome doctors in Delhi, India. Each of our doctors brings a wealth of experience and expertise in the field of nephrology, ensuring that patients receive comprehensive and specialised care based on their specific condition.

Reviewed by Dr. Yogesh Kumar Chhabra, Principal Consultant – Nephrology, Kidney Transplant on 06-Mar-2024.