Like nephritis, nephrotic syndrome is a form of glomerulonephritis. For most children, the cause of this disease is not known. In nephrotic syndrome, small filters – glomeruli – in kidneys are damaged, and proteins penetrate from the blood (through the glomeruli) into the urine. The volume of urine is also significantly reduced so that the fluid that needs to be excreted from the body begins to accumulate in the subcutaneous tissues.
There are two main symptoms of nephrotic syndrome. The first occurs as a gradual general swelling (over a few weeks) of the body due to fluid buildup (edema). The swelling is particularly pronounced around the eyes and on the face, and the stomach can be bloated.
Another major symptom is a large reduction in urine volume – sometimes at the fifth of the normal amount. The appearance of urine is usually normal.
Nephrotic syndrome is not common, although it affects soemwhat more children than nephritis. The disease usually begins between the second and the fourth year, and is more common in boys.
A child with nephrotic syndrome is susceptible to a variety of infections – e.g. peritonitis. But the main danger is that in approximately 10% of cases the disease can not be fully cured despite intensive treatment. In most of these children, chronic pyelonephritis develops in adulthood.
What to do?
Contact your doctor if edema develops on your child. The doctor will examine the child and take a sample of urine for laboratory analysis. If those tests point to nephrotic syndrome, the doctor will refer the child to hospital specialists for additional blood and urine tests (and kidney biopsy, if necessary).
Self-help: although the disease often requires hospitalization, you can help your child with special diets and by giving him medication exactly according to the physician’s instructions. Foods must be cooked and free of salt, and must contain a lot of protein (fish, meat, eggs and cheese). Your doctor will occasionally advise on taking limited ammounts of fluid.
Professional help: a child is usually received into a hospital in which it is easier to supervise taking medication and diet. Nephrotic syndrome is treated with corticosteroids. They are given in high doses, but the amounts gradually decrease and, after about eight weeks, the treatment with corticosteroid stops. Symptoms disappear at the end of the second week, and the child is released from the hospital. Approximately 50% of children are fully healed and the disease does not leave any consequences. In others, the condition will repeat after several weeks or months, and the same therapy will be re-applied. In a small number of patients, seizures of the nephrotic syndrome continue to recur and the condition eventually is cured by long-lasting treatment with medication (six months or one year).