Nephrotic Syndrome in Adults

Nephrotic syndrome is a condition marked by very high levels of protein in the urine (proteinuria); low levels of protein in the blood; swelling, especially around the eyes, feet, and hands; and high cholesterol. Nephrotic syndrome results from damage to the kidneys' glomeruli (the singular form is glomerulus). Glomeruli are tiny blood vessels that filter waste and excess water from the blood and send them to the bladder as urine.

Nephrotic syndrome can occur with many diseases, including the kidney diseases caused by diabetes mellitus, but some causes are unknown. Prevention of nephrotic syndrome relies on controlling these diseases.

Treatment of nephrotic syndrome focuses on identifying the underlying cause if possible and reducing high cholesterol, blood pressure, and protein in urine through diet, medications, or both. One group of blood pressure medications called ACE inhibitors also protects the kidneys by reducing proteinuria.

Nephrotic syndrome may go away once the underlying cause, if known, has been treated. In children, 80 percent of cases of nephrotic syndrome are caused by minimal change disease, which can be successfully treated with prednisone. However, in adults, most of the time the underlying cause is a kidney disease such as membranous nephropathy or focal segmental glomerulonephritis, and these diseases often persist even with treatment. In these cases, the kidneys may gradually lose their ability to filter wastes and excess water from the blood. If kidney failure occurs, the patient will need dialysis or a kidney transplant.