Nephrotic Syndrome – Diagnosis and Treatment
Diagnosis
Doctors use different tests and procedures to find out if a patient has nephrotic syndrome. Urine tests play a key role.
These tests check for heavy protein loss, also known as proteinuria, and may require a 24-hour urine collection to measure the amount of protein passed in the urine. This confirms signs like swelling, weight gain, and fluid retention.
Blood tests are another important step. Doctors check levels of albumin (a blood protein), total cholesterol, and kidney function by measuring creatinine and urea nitrogen. Low albumin with high cholesterol can signal nephrotic syndrome.
When the cause is unclear, doctors may perform a kidney (renal) biopsy. They remove a small piece of kidney tissue to check for problems like minimal change disease, membranous nephropathy, or focal segmental glomerulosclerosis.
Treatment
Treatment usually depends on the main cause and focuses on lowering symptoms and risks. Medicines play a key role in managing nephrotic syndrome.
- Blood Pressure Medicine: Angiotensin-converting enzyme inhibitors (ACE inhibitors) often help lower blood pressure and reduce the amount of protein in the urine. Angiotensin receptor blockers (ARBs) are used if ACE inhibitors do not work or cause side effects.
Diuretics (Water pills): Diuretics remove extra fluid and lower swelling. These medicines help the kidneys get rid of salt and water but may need monitoring to avoid dehydration.
Cholesterol-Lowering Medicine: Statins treat high cholesterol levels that are often present in nephrotic syndrome. It is not clear if these medicines lower the chance of a heart attack or protect the kidneys in the long term.
Blood Thinners: If patients have a high risk of blood clots, doctors may prescribe anticoagulants to help prevent excessive clotting.
Medicines to Lower the Immune System: In some cases, drugs that calm the immune system help lower inflammation and treat causes linked to the immune system.
Vaccines and immunizations help protect people from infections, as the disease and some treatments increase the risk of getting sick.
If nephrotic syndrome leads to advanced kidney disease, doctors may recommend treatments like dialysis. For end-stage kidney problems, a kidney transplant can be considered.
The right treatment plan depends on the cause of nephrotic syndrome, the personโs age, and other health problems.
| Medicine Type | Main Purpose |
|---|---|
| ACE Inhibitors | Lower blood pressure, reduce protein |
| ARBs | Lower blood pressure, reduce protein |
| Diuretics | Lower swelling |
| Statins | Lower cholesterol |
| Anticoagulants | Prevent blood clots |
| Immune Suppressors | Reduce immune system response |
People with nephrotic syndrome should follow their doctor’s advice, including making changes to their diet and getting regular checkups.
Tips for Managing at Home
Taking care of yourself at home is important when living with nephrotic syndrome. Focus on what you eat and drink. Here are some self-care steps:
- Limit Sodium: A low-salt diet can help control swelling.
- Watch Fluids: Sometimes, it is best to cut down on liquids if swelling is a problem.
- Choose Healthy Proteins: Lean and plant-based proteins support kidney health.
- Reduce Fat and Cholesterol: Eating less fat may help manage blood cholesterol.
| Focus Area | What to Do |
|---|---|
| Sodium | Eat less salt. |
| Protein | Pick lean or plant options. |
| Fat & Cholesterol | Eat less fatty foods. |
| Liquids | Drink smaller amounts if needed. |
Doctors may recommend talking to a dietitian for a plan that fits each person’s needs.
Getting Ready for Your Medical Visit
Steps You Can Take Ahead of Time
Before the appointment, check if you need to follow any special instructions, like changing your diet. If possible, bring a family member or friend to help remember the information the doctor provides.
Write down:
- Symptoms: List all symptoms you or your child are experiencing, and when they started.
- Important Personal Details: Note any major life events, stress, or changes.
- Medications and Supplements: Record all medicines, vitamins, and supplements being taken, including amounts.
- Questions for the Doctor: Prepare a list of questions you want to discuss.
Some questions people often ask their nephrologist include:
| Sample Questions |
|---|
| What could be causing this kidney problem? |
| What kinds of tests will be needed? |
| Is this condition likely to be short-term or longer-lasting? |
| Which treatments are available, and which do you suggest? |
| Should I adjust my or my child’s diet? Is it helpful to see a dietitian? |
| Can other health issues affect this condition? |
Questions Your Doctor Might Ask
The doctor will likely ask about symptoms and their pattern. Some sample questions are:
- Do the symptoms appear all the time, or only sometimes?
- How intense are the symptoms?
- Is there anything that makes the symptoms better or worse?
Answer these questions honestly and clearly so the nephrologist can understand the problem and find the best treatment plan.
