Is your body swelling? Is your urine foamy? Could this be nephrotic syndrome?

Do you sometimes wake up in the morning and feel puffy around your eyes? Or do your feet and ankles swell, making it difficult to put on your shoes? Have you ever noticed that your urine is foamier than usual? These are not just random things. There may be a problem with your kidneys behind these symptoms. Today we are talking about a medically important condition that arises from a combination of symptoms like these. That is Nephrotic Syndrome.

What exactly is Nephrotic Syndrome?

The first thing to understand is that this is not a specific disease. It refers to a collection of symptoms that can occur when our kidneys are not working properly. Think of our kidneys as a high-tech filter. Their main job is to clean our blood and remove unwanted waste and excess water from the body as urine. This filtering work is done by a very fine network of blood vessels in the kidneys. We call these glomeruli. In a healthy person, this filtering system does not allow things like proteins that are essential for the body to pass through. They are retained in the blood. But if these fine filters called glomeruli are damaged, a large amount of proteins that the body needs to pass through them and start to pass out with the urine. That is what we call nephrotic syndrome. This condition can affect adults as well as children, but the good news is that there is a treatment for it.

Why does this situation occur?

The reasons for this can be divided into two main parts.

Causes that affect only the kidneys (Primary Causes)

This means that nephrotic syndrome occurs due to a disease condition that occurs in the kidneys themselves, without the effect of any other disease.

• Minimal Change Disease: This is the main cause of nephrotic syndrome in children . Although their kidney tissue appears normal under a microscope, the filtration process is impaired. It is believed to be caused by viral infections , allergies , or certain medications (especially painkillers such as NSAIDs ).
• Focal Segmental Glomerulosclerosis (FSGS): This is a condition in which the filtering units (glomeruli) of the kidneys become scarred. This is the main cause of nephrotic syndrome in adults . Viruses such as HIV , certain medications, genetic factors, and obesity can all cause this condition .Many things, such as high blood pressure, can affect this.
• Membranous Nephropathy: This is a thickening of the membranes of the glomeruli. This can also be caused by conditions such as cancer, malaria, hepatitis B, and lupus.

Secondary causes of kidney damage due to other diseases

This means that nephrotic syndrome occurs when the kidneys are damaged as a side effect of another medical condition in the body.

• Diabetes : Diabetes is the most common secondary cause of nephrotic syndrome in adults. Uncontrolled diabetes can lead to kidney damage (diabetic nephropathy).
• Lupus: This is a chronic disease of the immune system that can cause serious damage to the kidneys.
• Amyloidosis: A type of protein called amyloid can build up in the blood, causing kidney damage.

What symptoms might you have?

There are four main symptoms of nephrotic syndrome. To understand these clearly, see the table below.

How does this situation affect young children?

Nephrotic syndrome is a relatively rare condition in young children. However, if a child does develop the condition, the symptoms may be slightly different.

• Swelling around the eyes, especially when waking up in the morning.
• Swelling of the face, hands, legs, and abdomen.
• Foamy urine.
• Feeling more tired and exhausted than usual.

Corticosteroids are the most commonly used treatment for children. These can often control symptoms and induce remission.

Doctor, how do you diagnose this?

If you have these symptoms, it's important to see a doctor as soon as possible. The doctor will first ask you about your symptoms. Then,

• Urine Test: This is essential to measure how much protein is excreted in the urine.
• Blood Tests: Check blood cholesterol, albumin levels, and other kidney functions.
• Kidney Biopsy: In some cases, it may be necessary to take a very small piece of tissue from the kidney and examine it under a microscope. This is what helps to determine exactly what is causing the kidney damage.

What complications can occur if left untreated?

If this condition is not treated properly, it can lead to other serious health problems.

• High cholesterol and heart disease risk: Elevated blood fat and cholesterol levels increase the risk of heart disease.
• High blood pressure: When the kidneys are damaged, their ability to remove sodium (salt) and fluid from the body decreases, which causes blood pressure to rise.
• Blood Clots:Because proteins that prevent blood clotting are excreted in the urine, the risk of blood clots in the body increases.
• Infections: As proteins such as immunoglobulins, which are essential for the body's immune system, are lost, there is a greater chance of contracting infections such as pneumonia.
• Kidney Failure: If left untreated for a long time, the kidneys can fail completely, requiring dialysis or a kidney transplant to survive.

What are the treatments for this?

The treatment plan depends on the underlying cause of your nephrotic syndrome.

Types of drugs

Your doctor may prescribe the following medications:

• Blood pressure medications: Medications like ACE inhibitors and ARBs reduce the pressure on the kidneys and reduce the excretion of protein in the urine.
• Diuretics: Also called "water pills," these help reduce swelling in the body.
• Cholesterol-lowering drugs.
• Blood thinners (Anticoagulants): Reduce the risk of blood clots.
• Immune-suppressing medications: Medications such as corticosteroids control the activity of the immune system and reduce damage to the kidneys.

This is why diet control is important

Along with medication, diet is also very important in managing this disease.

• Reduce salt (sodium): Eating too much salt can cause water retention, swelling, and high blood pressure. Avoid foods high in salt, such as sausages, cured meats, canned vegetables, soups, biscuits, and sauces.
• Reduce fat and cholesterol: Follow a diet low in saturated fat and cholesterol.
• Limit fluids: Sometimes your doctor will tell you to limit the amount of water you drink per day.

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