Childhood Nephrotic Syndrome
Nephrotic syndrome is a group of symptoms indicating kidney problems. Kidneys are the bean shaped organs, located at the lower back of the body. These are the primary organs involved in filtering liquid waste products, salt and excess water from the blood. Healthy kidneys help keep the required level of protein in blood, which soaks up excess water from the tissues. However, when there is a problem in the kidneys; this protein may get mixed up in the urine, thus causing water retention and swelling.
Though both adults and children get affected by nephrotic syndrome, the causes as well as treatment differ for both. Nephrotic syndrome in children commonly occurs between the age of 1 ½-5 years. In general it is seen to affect boys more than the girls. Nephrotic syndrome in children is characterized by less than required level of protein in the blood, excess of protein in the urine (proteinuria), infrequent urination, swelling due to water and salt retention, and sudden weight gain due to water retention. Though nephrotic syndrome itself is not categorized as a disease, it is indicative of beginning of some problem that may damage the kidney’s filtering unit called glomeruli, at a later stage.
In children, nephrotic syndrome is diagnosed by studying the urine sample of the child for level of protein in the urine. This is done by dipping a chemically treated piece of paper inside the urine. In case the level of protein is high, the paper would change color, indicating so. The doctor may also take a sample of blood to check if the kidneys are removing waste products such as urea nitrogen and creatinine from the blood. In case the levels of these materials are seen to be more than required, it indicates a problem in the kidneys. Though this may indicate some damage to the kidneys, it is not permanent in nature. In some cases the doctor may even carry out biopsy to check if there is any specific cause of nephrotic syndrome.
There are four conditions related to childhood nephrotic syndrome. These are:
Minimal Change Disease: This is the most common condition related to nephrotic syndrome. As the name suggests, this disease seemingly does not have any damage to the kidneys, where it can be treated through medications such as corticosteroids, which stop the leakage of protein into the urine. In some cases the doctor may prescribe diuretics, which are helpful in removing excess water through frequent urination.
Membranoproliferative Glomerulonephritis and Focal Segmental Glomerulosclerosis: About 20% of children diagnosed with nephrotic disease suffer from these conditions, which are characterized by deposits or scarring on the glomeruli. For treating this condition the doctor may prescribe additional medication such as cytotoxic agents and ACE inhibitors.
Congenital Nephropathy: This is a rare condition that occurs by birth and leads to nephrotic syndrome. Apart from this, diffuse mesangial sclerosis is another congenital condition that leads to nephrotic syndrome. This condition cannot be treated through surgery and requires kidney transplant. However, the child must be at least three years old, where he is in a condition to receive new kidney.
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