Nephrotic syndrome is characterized by high protein excretion, peripheral edema, and metabolic abnormalities .Consists of clinical and laboratory abnormalities common to several primary and secondary kidney diseases, each characterized by increased permeability of the glomerular capillary wall to circulating plasma proteins, particularly albumin .Presents with edema, hypoalbuminemia, and massive proteinuria (3.5 g/24 h or greater), hypertension, and hyponatremia.
The cause is damage to the glomeruli, which can be the cause of the syndrome or caused by it, that alters their capacity to filter the substances transported in the blood. The severity of the damage caused to the kidneys can vary and can lead to complications in other organs and systems. However, patients suffering from the syndrome have a good prognosis under suitable treatment.
Many diseases and conditions can cause glomerular damage and lead to nephrotic syndrome, including:
Minimal change glomerulopathy:
Accounts for 80% of cases of nephrotic syndrome in children younger than 10 years, approximately 50% of cases in older children, and 10% to 15% of cases in adults.
No cause is found in most patients. Disease is immunologically mediated and related to abnormal T-cell function rather than immune-complex deposition.
Patients usually present with full-blown pure nephrotic syndrome.
Focal segmental glomerulosclerosis
Focal segmental glomerulosclerosis (FSGS): is the most common cause of nephrotic syndrome in adults. It is characterized by the appearance of tissue scarring in the glomeruli. The term focal is used as some of the glomeruli have scars, while others appear intact; the term segmental refers to the fact that only part of the glomerulus suffers the damage.
This kidney disorder is the result of thickening membranes within the glomeruli. The exact cause of the thickening isn't known, but it's sometimes associated with other medical conditions, such as hepatitis B, malaria, lupus and cancer.
Systemic lupus erythematosus
This chronic inflammatory disease can lead to serious kidney damage.
Diabetic nephropathy: is a complication that occurs in some diabetics. Excess blood sugar accumulates in the kidney causing them to become inflamed and unable to carry out their normal function. This leads to the leakage of proteins into the urine.
Children with nephrotic syndrome will outgrow it by the time they reach young adulthood. In the rare case when a child needs a kidney transplant, we have a protocol that decreases the chance that the nephrotic syndrome re-appears in the new organ from 50 percent to 20 to 30 percent