What is nephrotic syndrome?

Nephrotic syndrome is condition where there is damage to the part of the kidney cells that that filter your blood. This damage can be caused by many different kidney problems.

A key role of the kidneys is to filter blood. Your kidneys also remove waste products, extra fluid and salts in urine (wee). This happens in the part of your kidneys called the glomeruli.

If the glomeruli become damaged, proteins such as albumin can leak into the urine.

Nephrotic syndrome is defined by 3 features:

• high levels of protein in your urine
• low levels of albumin in your blood
• generalised swelling of your body

What are the symptoms of nephrotic syndrome?

One of the most common symptoms of nephrotic syndrome is fluid retention. This causes puffy eyes, a swollen abdomen (tummy), swollen ankles and feet, as well as weight gain.

Other symptoms can include:

• frothy urine
• blood in urine
• feeling dizzy
• anaemia causing tiredness or breathlessness

Nephrotic syndrome can lead to serious illness such as infections, blood clots and kidney failure.

If you are worried that you or your child could have nephrotic syndrome, speak to your doctor.

What causes nephrotic syndrome?

Nephrotic syndrome can be caused by many different diseases — some specifically affect the kidneys, while other affect other organs or your whole body.

Kidney diseases that commonly cause nephrotic syndrome include:

• a kidney disease called minimal change disease
• focal segmental glomerulosclerosis
• membranous glomerulonephritis

Some conditions that affect the whole body can cause nephrotic syndrome. These include:

• diabetes mellitus
• lupus
• amyloidosis
• some types of cancers
• some infections, such as hepatitis B or malaria

Nephrotic syndrome can also be caused by a reaction to some medicines including anti-inflammatory medicines (NSAIDs).

How is nephrotic syndrome diagnosed?

To diagnose you with nephrotic syndrome, your doctor is likely to:

• ask you about your medical history and your symptoms
• examine you
• ask you to do a series of urine tests
• take a blood sample for testing

Some people might need a biopsy of their kidney. This involves taking a sample of your kidney cells which are looked at under a microscope to confirm the cause of nephrotic syndrome.

How is nephrotic syndrome treated?

If the cause of kidney damage is known then your doctors will treat the condition, if possible. Treatment may involve medicines that suppress your immune system, including steroids.

You might also need medicines to manage the symptoms and other issues, such as:

• fluid tablets (diuretics)
• blood pressure medicine — to reduce the pressure of the blood flowing through the filtering system of your kidneys, so that less protein is filtered out into your urine
• cholesterol lowering medicine (statins)
• pneumococcal and influenza vaccinations
• anti-clotting medicine — to treat or reduce the risk of blood clots forming

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

Self-care for nephrotic syndrome

While it’s essential that you follow your doctor’s advice on medicines carefully, there are some self-care steps you can do to help manage nephrotic syndrome.

It is important to follow the right diet for your condition. Your doctor is likely to recommend a diet with:

• very little salt
• a limit on how much fluid you drink
• protein, but not a high protein diet
• low fat

As your doctor to refer you to a dietitian to help you make the right food choices.

Resources and support

Kidney Health Australia has a factsheet covering some causes of nephrotic syndrome.

Queensland Health has information about diet and medicines in nephrotic syndrome.

If you or your child has nephrotic syndrome, use the Dietitians Australia search tool to find an Accredited Practising Dietitian (APD) near you to support your health needs.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.