Nephrotic syndrome: MedlinePlus Medical Encyclopedia (original) (raw)

Nephrotic syndrome is a group of symptoms and abnormal test results that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, increased blood clot risk, and swelling.

The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life.

Treatments may include any of the following:

• Keeping blood pressure at or below 130/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine.
• Corticosteroids and other drugs that suppress or quiet the immune system.
• Treating high cholesterol to reduce the risk for heart and blood vessel problems -- A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed.
• A low-sodium diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem.
• Low-protein diets may be helpful. Your provider may suggest a moderate-protein diet (1 gram of protein per kilogram of body weight per day).
• Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment.
• Taking blood thinner drugs to treat or prevent blood clots.

The outcome varies. Some people recover from the condition. Others develop long-term kidney disease and need dialysis and eventually a kidney transplant.

Contact your provider if:

• You or your child develops symptoms of nephrotic syndrome, including swelling in face, belly, or arms and legs, or skin sores
• You or your child are being treated for nephrotic syndrome, but symptoms don't improve
• New symptoms develop, including cough, decreased urine output, discomfort with urination, fever, severe headache

Go to the emergency room or call the local emergency number (such as 911) if you have seizures.

Treating conditions that can cause nephrotic syndrome may help prevent the syndrome.

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Radhakrishnan J, Stokes MB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 107.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Primary glomerular disease. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 31.

Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.