Nephrotic syndrome is characterized by the following symptoms that result from changes that occur to the small, functional structures in the kidneys, such as:
The type of nephrotic syndrome that is most common in children is called idiopathic nephrotic syndrome. Idiopathic means that a disease occurs with no known cause. The most common type of idiopathic nephrotic syndrome is called minimal-change nephrotic syndrome (MCNS). Idiopathic nephrotic syndrome is more common in boys than girls.
With MCNS, the child usually has relapses of the illness, but the disease can usually be managed and prognosis is good. In rare cases, a child may develop kidney failure that requires dialysis.
There is a rare nephrotic syndrome present in the first week of life called "congenital nephrotic syndrome." Congenital nephrotic syndrome is inherited by an autosomal recessive gene, which means that males and females are equally affected, and the child inherited one copy of the gene from each parent, who are carriers. The chance for carrier parents to have a child with congenital nephrotic syndrome is one in four, or 25 percent, with each pregnancy. The outcome for this type of nephrotic syndrome is extremely poor.
The following are the most common symptoms of nephrotic syndrome. However, each child may experience symptoms differently. Symptoms may include:
The symptoms of nephrotic syndrome may resemble other conditions and medical problems. Always consult your child's physician for a diagnosis.
In addition to a thorough physical examination and complete medical history, your child's physician may recommend the following diagnostic tests:
Specific treatment for nephrotic syndrome will be determined by your child's physician based on:
During the initial episode of nephrotic syndrome, your child may require hospitalization. He/She may need to be monitored if the edema is severe or if he/she has blood pressure and/or breathing problems.
Medications may be required to treat initial symptoms and during relapses, including:
The medications used to treat nephrotic syndrome weaken the immune system so your child should not receive live vaccines. If your child has been exposed to chickenpox and has not already had the vaccine, the vaccine may be recommended.
Relapses do occur throughout childhood. However, once a child reaches puberty, the disease usually stays in remission (complete or partial absence of symptoms). It is uncommon for symptoms to return during adulthood; however, it is possible.