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Nephrotic Syndrome

Illustration of the anatomy of the kidney
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What is nephrotic syndrome?

Nephrotic syndrome is a condition often characterized by the following:

  • Very high levels of protein in the urine

  • Low levels of protein in the blood

  • Swelling, especially around the eyes, feet, and hands

  • High cholesterol

What causes nephrotic syndrome?

Generally, nephrotic syndrome results from damage to the kidneys' glomeruli—the tiny blood vessels that filter waste and excess water from the blood and send them to the bladder as urine. Glomeruli keep protein in the body. When they are damaged, protein leaks into the urine. Healthy kidneys allow less than 1 gram of protein to spill into the urine in a day. In nephrotic syndrome, the glomeruli allow 3 grams or more of protein to leak into the urine during a 24-hour period. Nephrotic syndrome may occur with many diseases, including the kidney diseases caused by type 2 diabetes. What causes nephrotic syndrome is not always known. 

What are the symptoms of nephrotic syndrome?

Nephrotic syndrome is actually a set of symptoms and not a disease in and of itself. The following are the most common symptoms of nephrotic syndrome. However, each individual may experience symptoms differently. Symptoms may include:

  • High blood pressure

  • Swelling in the feet and hands, and around the eyes

  • Susceptibility to infections

The symptoms of nephrotic syndrome may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is nephrotic syndrome diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for nephrotic syndrome may include the following:

  • Measurement of blood pressure

  • Measurement of blood cholesterol levels

  • Measurement of protein levels in the urine

  • Measurement of protein levels in the blood

What is the treatment for nephrotic syndrome?

Specific treatment for nephrotic syndrome will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment generally focuses on identifying the underlying cause, if possible, and reducing the following (often through diet, medications, or both):

  • High cholesterol

  • Blood pressure

  • Protein in urine

ACE inhibitors (one type of blood pressure medication) may be used in people with diabetes to protect the kidneys. Consult your doctor to determine if an underlying cause for your condition can be identified. Only after this determination is made can an appropriate treatment protocol be established. A special diet can help some people delay the need for dialysis.