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ISSN 0973 - 0958
Nephrotic Syndrome(NS) in Children
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NEPHROTIC SYNDROME
Q1) What is nephrotic syndrome?
A1) Nephrotic Syndrome is a common disease in children involving Kidneys.
Q2) How does it occur?
A2) It occurs due to loss of proteins in the urine in large quantities which reduces the amount of protein in blood. Normally as little as 150 mg of protein is excreted in urine by kidneys in a day whilst in Nephrotic Syndrome 2-20 gm may be lost.
A1) Nephrotic Syndrome is a common disease in children involving Kidneys.
Q2) How does it occur?
A2) It occurs due to loss of proteins in the urine in large quantities which reduces the amount of protein in blood. Normally as little as 150 mg of protein is excreted in urine by kidneys in a day whilst in Nephrotic Syndrome 2-20 gm may be lost.
Q3) How shall the patient present?
A3) Patients present with swelling around eyes in the morning in the early stage, which subsequently spreads to legs, back, abdomen and whole body. Child may also pass less urine during this time.
Q4) How do you diagnose the condition?
A4) Diagnosis of NS is by a simple urine examination. Urine tests are positive for protein (3+ to 4+).
Q5) What is the treatment?
A5) In majority of children the cause of nephrotic syndrome is not known hence there is no curative treatment. But oral prednisolone treatment is effective in controlling the protein loss in the urine which is the main problem in NS.
Q6) How do you monitor the patient?
A6) Since the total course of prednisolone is for 2-3 months, weekly examination of urine to detect its effect on protein loss is important. Once the protein loss is controlled, once every 2-4 weeks the urine test should be done to diagnose recurrence of the disease or relapse which is diagnosed by reappearance of 3+ to 4+ proteins in urine. B.P.record, weight of the child, urine output also should be checked periodically.
Q7) What precautions does the patient take?
A7) The main precautions to be taken are avoidance of infection because infections are known to cause relapses and in severe cases death . Boiling the drinking water, avoiding contact with patients with infections like chickenpox, jaundice, typhoid etc. and giving vaccinations against the above mentioned diseases are important steps to prevent infections in NS. There is increased risk of complications in a child with NS due to infections which may be mild in healthy children.
Q8) What are the chances of recurrence?
A8) Chances of recurrence or relapse of NS is as high as 50-75% in a Nephrotic child.
Q9) What to do in case of a relapse?
A9) In case of relapse the first step is contact your doctor to treat the infection which might be responsible for the relapse.
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Kidney Problems in Children Specialist
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