Nephrotic Syndrome: Diagnosis, Symptoms, Causes



It is a kidney disorder that causes the body to eliminate too much protein in the urine. It is usually caused by damage to groups of small blood vessels in the kidneys that filter waste and excess water into the blood.

The nephrotic syndrome causes swelling, called edema , mainly in the feet and ankles, and increases the risk of other health problems.


  • High levels of protein in the urine.
  • Low protein in the blood due to a leak.
  • Swelling, usually around the eyes, feet and hands and sometimes edema with fovea.
  • Swollen eyes.
  • Weight gain due to fluid retention.
  • High blood pressure.


  • Urinalysis: determines the amount of protein in the urine.
  • Blood test: determines the levels of creatinine, albumin, cholesterol, and many other factors examined in order to rule out other causes.
  • Glomerular filtration rate (GFR): it is an estimator of renal function by calculating the levels of creatinine in the blood with protein levels in the urine.
  • Kidney biopsy: It is sometimes done to examine a small portion of the kidney under a microscope.
  • Kidney ultrasound or CT Scan: is sometimes done to get a closer look at the kidneys.

Causes nephrotic syndrome

Various diseases and conditions can cause glomerular damage and lead to nephrotic syndrome:

Minimal change disease . It is the most frequent cause of nephrotic syndrome in children, causing abnormal renal function, however, when the kidney tissue is examined under a microscope, it appears to be normal. The origin of the abnormal function has typically not yet been determined.

Focal and segmental glomerulosclerosis . Characterized by the scattered healing of some of the glomeruli, this condition can be the result of another disease, a genetic defect or for unknown reasons.
Membranous nephropathy.

This kidney disorder is the result of the thickening of the membranes within the glomeruli. The exact cause of thickening is unknown, but it is sometimes associated with other medical conditions, such as hepatitis B, malaria, lupus and cancer.

Diabetic kidney disease . Diabetes can cause kidney damage (diabetic nephropathy) affecting the glomeruli.

Systemic lupus erythematosus . It is a chronic inflammatory condition, which can lead to severe kidney damage.
Amyloidosis. This disorder occurs when substances called amyloid proteins pile up in organs. The buildup of amyloid often affects the kidneys, and causes damage to the filtration system.

Blood clot in a renal vein . Also called thrombosis of the renal vein, which occurs when a blood clot blocks a vein connected to the kidney.

Heart failure . Some forms of heart failure, such as constrictive pericarditis and right heart failure, can cause nephrotic syndrome.


Medications for blood pressure. Called inhibitors of the converting enzyme, they reduce blood pressure and also reduce the amount of protein released in the urine. Medications in this category include benazepril (Lotensin), captopril (Capoten) and enalapril (Vasotec).

Water pills . Diuretics, help reduce inflammation by increasing the production of fluid from the kidneys. Some diuretics can be: furosemide (Lasix) and spironolactone (Aldactone).

Anticoagulants . They help decrease the ability of blood to clot and reduce the risk of developing clots. Anticoagulants include heparin or warfarin (Coumadin).

Immuno-suppressive drugs . Medications to control the immune system, such as corticosteroids, can decrease the inflammation that accompanies certain kidney disorders, such as minimal change disease.

Lastly, it is important to remember that changes in diet can help you cope with nephrotic syndrome. A dietitian can help deal with the complications of nephrotic syndrome and recommend:

  • Sources of lean protein
  • Reduce the amount of fat and cholesterol in the daily diet.
  • Eat a low-salt diet to help control swelling (edema).