Specific treatment of nephrotic syndrome depends on the disease's cause

Nephrotic syndrome

Nephrotic syndrome can occur in anyone. The syndrome arises for many reasons, including a condition known as minimal change disease in children and glomerulonephritis (kidney inflammation) in adults. Nephrotic syndrome can also be caused by infection, medication side effects, heredity, cancer, and autoimmune disorders, such as diabetes and lupus.

The role of preventive anticoagulation in nephrotic syndrome has been reported, but there is no proof that it is beneficial.

Hyperlipidemia occurs in nephrotic syndrome, and it can be controlled with lipid-lowering agents. Older studies have reported a predisposition to atherosclerosis in patients with nephrotic syndrome, but there are no data to show that lipid-lowering drugs improve renal or patient outcomes.

Specific treatment
Specific treatment of nephrotic syndrome depends on the disease's cause. In minimal-change nephropathy, glucocorticosteroids, such as prednisone, are used.[35] Children who relapse after successful use of prednisone or who do not respond to prednisone (ie, those with steroid-resistant disease) may be treated with rituximab, an antibody against B-cells. Rituximab has also been used in membranous nephropathy in adults.[36]

In some forms of lupus nephritis, prednisone and cyclophosphamide are useful.

Secondary amyloidosis with nephrotic syndrome may respond to anti-inflammatory treatment of the primary disease.

Diet and activity
The diet in patients with nephrotic syndrome should provide adequate energy (caloric) intake and adequate protein (1-2 g/kg/d). Supplemental dietary protein is of no proven value. A diet with no added salt will help to limit fluid overload.

Management of hyperlipidemia could be of some importance if the nephrotic state is prolonged. Fluid restriction per se is not required.

There are no activity restrictions for patients with nephrotic syndrome. Ongoing activity, rather than bedrest, will reduce the risk of blood clots.

How the Kidneys Work
The kidneys are a pair of bean-shaped organs located toward the back of the abdominal cavity, just above the waist. The kidneys remove waste products and extra water from the food a person eats, returning chemicals the body needs (such as sodium, phosphorus, and potassium) back into the bloodstream. The extra water combines with other waste to become urine (pee).

The main functional units of the kidneys, where the blood filtering happens, are tiny organs called nephrons. Each kidney has about a million nephrons, and each nephron has one glomerulus (singular of glomeruli) — a ball of tiny blood vessels, or capillaries. The glomerulus is the nephron's filter. This is where the process of removing waste products and fluids from the blood begins.

When the glomeruli stop filtering properly, they allow too much protein to leave the blood. Protein helps hold fluids in the blood, so when there is less protein in the blood, the fluids can move to other parts of the body and cause a type of swelling (edema) in the face, belly, hands, arms, and other extremities. When this happens, it's called nephrotic syndrome.