Nephrotic Syndrome in Children: Causes and Treatment

Swelling and sudden weight gain are two of the main symptoms of nephrotic syndrome in children. Find out more in this article.
Nephrotic Syndrome in Children: Causes and Treatment

Last update: 05 February, 2020

The amount of children that have nephrotic syndrome is about 15 cases out of every 100,000 children, according to the Spanish Association of Pediatrics.

However, what exactly is this disease? What are its possible causes and treatments?

In this article, we’ll tell you all about it.

What is nephrotic syndrome in children?

To understand what this syndrome is, we must first explain how your kidneys work. These two bean-shaped organs are just above the hip. In fact, they’re responsible for filtering the blood to:

  • Remove waste from the body, including excess water.
  • Recover elements like potassium, phosphorus, and sodium and return them to the bloodstream.

Each kidney has about a million nephrons. These are small organs that have a filter called the glomerulus. The glomerulus is responsible for clarifying and filtering the plasma in your blood. When it doesn’t work properly, you may pass too much protein into your kidneys.

One of the functions of proteins, and albumin, in particular, is to keep fluids within the bloodstream. Thus, if proteins pass into the urine (the mixture of excess water and waste), the fluids “escape” from the blood and can cause swelling in your limbs, arms, hands, and other body parts.

Symptoms of nephrotic syndrome in children

Diarrhea and abdominal pain are two possible symptoms of nephrotic syndrome.

Children who suffer from nephrotic syndrome have, in addition to extra protein in their urine, a sudden increase in weight and swelling in their abdomen, face (especially around the eyes), and extremities. In the latter case, this mainly causes swelling in their ankles and toes after standing or sitting for a long time

While these are the main and most obvious symptoms, they aren’t the only ones. Children with this condition may also have:

  • Diarrhea
  • Trouble urinating
  • Dark and foamy urine
  • Fatigue
  • Abdominal pain
  • White skin around the nails
  • Lack of appetite

Three causes of nephrotic syndrome in children

Childhood diabetes is the third most common cause of nephrotic syndrome in children.

Nephrotic syndrome in children is idiopathic. In other words, idiopathic means that doctors aren’t sure exactly what causes it in 90% of children aged 2 to 12 suffering from this disease.

Usually, these children have what appear to be normal kidneys. That is, doctors can’t tell what’s wrong with their kidneys even under a microscope. The renal tissue looks normal, and it’s usually impossible to determine the cause.

The second most common cause in children is juvenile diabetesThis can damage the kidneys by affecting the glomeruli and preventing them from deciding what is waste and what is useful.

The third cause is genetic mutations. Generally, nephrotic syndrome is considered genetic. However, in children under 12 months old, it’s considered a congenital nephrotic syndrome.

Possible treatments

It's important to talk to your pediatrician about your child's nephrotic syndrome

If you think your child has nephrotic syndrome, talk to your doctor. Then, she or he will probably want a urine sample to see if there is excess protein.

Afterward, your doctor will try to determine the causes to choose the best possible treatment. Additionally, s/he may want to run blood tests and even a renal biopsyIn the biopsy, he will analyze a small tissue sample.

Usually, the nephrologist will recommend treatment with corticosteroids, except in congenital cases. Also, if there are side effects with this type of medication, your doctor may try other types like cyclophoshamide or anticalcineurinics. Plus, your doctor may suggest using diuretics to help treat swelling. For the same reason, low sodium diets are ideal for children suffering from this condition.

Many children with genetic nephrotic syndrome don’t usually respond to treatment. However, there’s research that suggests that immunosuppressants may work in certain patients. Ultimately, your doctor will find the best treatment for your child’s specific needs.

If you think your child may have nephrotic syndrome, call your doctor. She or he will let you know if you should make an appointment with a nephrologist.As we always say: nobody can advise you better than a specialist.

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