Nephrotic Syndrome - How To Detect It?

The nephrotic syndrome refers to kidney disease. Nephrotic syndrome is triggered when the glomeruli (tiny structures in the kidneys) malfunction or are damaged and allow too much protein to enter into the kidneys. Nephrotic syndrome is a chronic ailment but not very prevalent. In India, fewer than 1 million cases are reported every year.

Who is susceptible to Nephrotic Syndrome?
Children, especially between the ages 2-6 are vulnerable to coming down with this ailment. It is prevalent more amongst male children than female. Around 3-4 children out of 100,000 are affected by it. Age of onset determines how severe the syndrome will be.

What are the symptoms of Nephrotic Syndrome?
Nephrotic syndrome is characterized by swelling up of the face. The swelling spreads to other parts of the body. This is when most doctors will recommend a urine test to confirm if the child has contracted nephrotic syndrome.

Diagnosis of the disease-
Nephrotic syndrome can be diagnosed following procedures to test the presence of high cholesterol and low albumin levels in the blood. The doctor will also document the ratio of urinary protein to creatinine of more than 2 to confirm the diagnosis.

Nephrotic syndrome treatment-
The treatment options for the symptoms of nephrotic syndrome are as follows-

• If nephrotic syndrome is detected in children less than 3 months of age, they will only require albumin transfusion and diuretic medication. For older children, oral steroids are trusted medication only after determining that there are no underlying diseases.
• Parental counselling is necessary so that they can understand the medicine dosage, duration and side effects of steroidal treatment. Parents need to purchase uristix that can reveal protein levels in urine. It is imperative that parents regularly monitor their child’s urine. This way, the syndrome does not become aggravated and the child does not need to be hospitalized.

Medication for nephrotic syndrome can be steroid sensitive or steroid insensitive.
• In the case of steroid-sensitive medicines, swelling keeps recurring frequently or infrequently. But it is not followed by an infection. These are called relapses that require other immunosuppressive drugs. Regular follow up is recommended.
• For steroid resistant medication, a kidney biopsy is mandated to understand the underlying cause of nephrotic syndrome. Based on the test results, the doctor initiates calcineurin inhibitor therapy. This procedure is performed by a pediatric nephrologist in children.

The dosage depends on the child’s weight. Inadequate or overdose can harm the child.

The side effects of steroids include-

• Cushingoid facies (fat deposits on the face)
• Hypertension
• Obesity
• Short stature

When a child takes immunosuppressive drugs, she/he becomes exposed to infections and might require vaccinations (Oral OPV i.e. pulse polio program, BCG, measles, MMR vaccine).

Diet for nephrotic syndrome-
A proper diet can work wonders in controlling the symptoms of nephrotic syndrome. A doctor usually recommends cutting down on salt and advises minimum intake of fluids. Since cholesterol levels go up with this syndrome, a diet low in saturated fats is suggested. Even though nephrotic syndrome is accompanied by loss of proteins, a high protein diet is not recommended because proteins aggravate the syndrome.

When the underlying causes of nephrotic syndrome (other diseases that trigger it) are cured, the symptoms of nephrotic disorder dissipate. The proper diet and medication will ensure that a child outgrows the disease and lives a healthy life.