Is Nephrotic Syndrome Summary likely to recur? NEPHROTIC
Approximately 70% of children with minimal
a condition that most children outgrow.
change lesion have recurrences of oedema.
This is more likely to occur at the same time
to occur with the common cold. Prednisolone
is very effective in controlling the urine protein
as a common cold. The urine can be tested
leak in the majority of cases. Every effort
at home. The first sign of recurrence is an
should be made so that the child continues
in Children
excessive amount of protein on the dip stick.
Swelling does not occur until excessiveprotein has been present in the urine for some days. If either occurs the parent shouldcontact their doctor and drug managementcan be started. When relapses becomefrequent the child may remain on prednisolonefor some months or years depending on therecurrence rate. Side effects from theprednisolone can occur and include obesity,roundness in the face, a decrease in growthrate and small cataracts. The other medicationslisted above are given at certain times toprevent these complications. The majority of children who have relapses stop relapsingby the age of 16 years. If the nephrotic syndrome does not respondto the prednisolone a renal biopsy is usuallyperformed. A small percentage of childrenwith other forms of nephrotic syndrome do not respond to drug therapy and they may develop kidney failure. In these patientsmedications that act on the kidney
RENAL RESOURCE CENTRE, 2007 RENAL RESOURCE CENTRE, 2007
to increase urine output will decrease the
amount of oedema. If high blood pressure
is present then it is important that this
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Publications of the Renal Resource Centre are endorsed byPublications of the Renal Resource Centre are endorsed byThe Australian and New Zealand Society of NephrologyThe Australian and New Zealand Society of NephrologyWhat is Types of Treatment Nephrotic Syndrome? Nephrotic Syndrome
As the child is losing excessive protein in the
Nephrotic syndrome occurs when the filters
The commonest type of nephrotic syndrome
urine a good diet is necessary. A normal or high
in the kidney leak an excessive amount of
in children is called “minimal change” and
protein diet is encouraged. Mild reduction of
protein. The level of protein in the blood then
occurs in 80% of cases. In this type, the kidney
fluid intake will assist in preventing excessswelling of the tissues. Salt reduction should be
falls and this allows fluid to leak across very
function remains normal. A small percentage
encouraged by not adding salt to the food. Most
small blood vessels into the tissues. Swelling
of children may have partial scarring involving
children can continue with normal activities.
around the eyes, abdomen and legs is then
some of their filters, while others may have
noted. Protein in the body is normally made
syndrome respond to drug therapy. Prednisolone
by the liver and the liver then responds by
(a steroid medication) is the initial drug used
producing extra protein. Nephrotic syndrome
with “minimal change” nephrotic syndrome.
is a combination of proteinuria (excessive
protein in the urine), low blood protein and
of protein within 2-3 weeks. Prednisolone can
What causes Nephrotic Syndrome?
Most cases of nephrotic syndrome are caused
types of white cells produce a substance that
acts on the filters in the kidney to produce
a change in the filters. This allows protein
nephrotic syndrome are caused by swelling
Are there any
and increased cell numbers in the filters. In
Complications?
some instances this may result in permanent
infrequent but the child should see their doctor
with any fevers or tummy pain. Clotting of a
if a child develops severe tummy pain with
a small needle is inserted into the kidney
frank blood in the urine. With the low blood
protein, the circulating blood volume may
by producing less urine. This is more likely
to occur if a child becomes ill with vomiting
or diarrhoea. This complication is easily
treated by infusion of protein into a vein.
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