by EBSCO Medical Review Board
(Nephrosis—Child)

Definition

Nephrotic syndrome is a group of changes affecting the kidneys. These may involve:

  • High amounts of protein in the urine
  • Swelling in the body—mainly in the feet and legs
  • Low levels of a protein called albumin in the blood
  • High cholesterol in the blood
Anatomy of the Kidney
Glomerulonephritis
Copyright © Nucleus Medical Media, Inc.

Causes

The kidneys filter waste from the blood and make urine. This problem happens when tiny filters in the kidneys leak too much protein into urine.

In most children, the cause is not known. In others, the most common cause is minimal change disease. This is damage to the filters due to things like infections, tumors, allergic reactions, and certain medicines.

Other health problems that can damage the kidneys can also lead to nephrotic syndrome.

Risk Factors

This problem can affect children of any age. It is more common in boys. Other things that may raise the risk are:

  • Health problems that can damage the kidneys
  • Taking certain medicines
  • Certain infections, such as cytomegalovirus and HIV

Symptoms

Problems may be:

  • Lack of energy
  • Pale skin
  • Lack of hunger
  • Foamy urine
  • Swelling of feet, ankles, and legs and less often the belly, hands, and face
  • Weight gain
  • Mood changes
  • Breathing problems

There may be times when the syndrome does not cause problems. There may be other times when symptoms are more active.

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical exam will be done. You will be checked for swelling in the body. This may be enough to suspect the diagnosis.

Blood and urine tests will be done to look at protein levels. This can confirm the diagnosis.

Treatment

Any underlying causes will need to be treated. Care will be given by a doctor who treats the kidneys.

Nephrotic syndrome often goes away on its own. Some treatment options are:

Dietary Changes

Salt, fats, cholesterol, and fluids may need to be limited. This can help ease problems, such as swelling.

Medicines

Medicine may be given to:

  • Control the immune system and improve kidney function—corticosteroids
  • Remove extra fluid—diuretics
  • Lower blood pressure

Medicines that may be causing harm to the kidneys may also need to be stopped or changed.

Prevention

There are known methods to prevent this health problem.

RESOURCES

Kids Health—Nemours Foundation  http://kidshealth.org 

National Institute of Diabetes and Digestive and Kidney Disorders  https://www.niddk.nih.gov 

CANADIAN RESOURCES

Caring for Kids—Canadian Paediatric Society  https://www.caringforkids.cps.ca 

The Kidney Foundation of Canada  https://www.kidney.ca 

References

Childhood nephrotic syndrome. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/children/childhood-nephrotic-syndrome. Accessed August 31, 2021.

Childhood nephrotic syndrome. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/childns. Accessed August 31, 2021.

Nephrotic syndrome. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/nephrotic-syndrome.html. Accessed August 31, 2021.

Nephrotic syndrome in children. Children’s Hospital of Philadelphia website. Available at: http://www.chop.edu/conditions-diseases/nephrotic-syndrome-children. Accessed August 31, 2021.

Nephrotic syndrome in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nephrotic-syndrome-in-children-21. Accessed August 31, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kuenn, MD
  • Review Date: 07/2021
  • Update Date: 08/31/2021