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Nephrotic Syndrome Treatment

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Nephrotic syndrome - Treatment in India

Nephrotic syndrome is a disorder caused by damage to the small blood vessels in your kidneys that filter waste and excess water from your blood. When healthy, these small blood vessels keep blood protein from seeping into your urine and out of your body. When damaged, they don't perform this function effectively, and protein can leak out of your blood and lead to swelling (edema).

Treatment for nephrotic syndrome includes treating the underlying condition that's causing it and taking medications. Nephrotic syndrome can increase your risk of infections and blood clots. Your doctor may recommend steps to prevent these and other complications of nephrotic syndrome.

Symptoms of Nephrotic syndrome

Signs and symptoms of nephrotic syndrome include : -

  • Swelling (edema), particularly around your eyes and in your ankles and feet
  • Foam in the toilet water, which may be caused by excess protein in your urine
  • Weight gain due to excess fluid retention
  • Loss of appetite
  • Vomiting

Causes of Nephrotic syndrome

Nephrotic syndrome is caused by damage to the tiny blood vessels (glomeruli) of your kidneys.

Your kidneys are two bean-shaped, fist-sized organs situated at the small of your back, just below your rib cage, one on each side of your spine. Blood enters your kidneys through arteries from your aorta, the large artery that carries blood away from your heart. Each kidney contains approximately 1 million glomeruli (the singular word form is glomerulus), each of which is attached to the opening of a small fluid-collecting tube (tubule). Each glomerulus and its tubule form a nephron, the functional unit of the kidneys.

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A filtering role

The glomeruli filter your blood as it passes through your kidneys. After being filtered by the glomeruli, blood travels through veins in your kidneys back to your bloodstream. The filtered substances, after being modified by the tubules, go through a tube from each kidney (ureter) to your bladder and pass out of your body when you urinate.

Every day about 2 quarts of water, along with waste products and electrolytes, leave your body as urine. When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body, a condition known as kidney failure.

What happens in nephrotic syndrome ?

Healthy glomeruli keep blood protein (mainly albumin) - which is needed to maintain the right amount of fluid in your body - from seeping into your urine. When damaged, glomeruli often lose this ability. Loss of blood protein leads to nephrotic syndrome, which is characterized by : -
  • High levels of protein in your urine (proteinuria)
  • Low levels of the blood protein albumin (hypoalbuminemia)
  • Elevated blood levels of cholesterol and triglycerides
  • Swelling (edema)

Many possible causes

Many disorders can cause glomerular damage and lead to nephrotic syndrome. The following medical conditions account for most cases of nephrotic syndrome : -
  • Minimal change disease : - The most common cause of nephrotic syndrome in children, this disorder results in abnormal kidney function, but when the kidney tissue is examined under a light microscope, it appears normal or nearly normal. The cause of the abnormal function typically can't be determined.

  • Focal segmental glomerulosclerosis : - Characterized by scattered scarring of some of the glomeruli, this condition may result from another disease, a genetic defect or occur for no known reason.

  • Membranous nephropathy : - This kidney disorder is the result of thickening membranes within the glomeruli. The exact cause of the thickening isn't known, but it's sometimes associated with other medical conditions, such as hepatitis B, malaria, lupus and cancer.

  • Diabetic kidney disease : - Diabetes can lead to kidney damage (diabetic nephropathy) that affects the glomeruli, particularly in people with diabetes that's poorly controlled or people who have high blood pressure.

  • Systemic lupus erythematosus : - This chronic inflammatory disease can lead to serious kidney damage.

  • Amyloidosis : - This disorder occurs when substances called amyloid proteins accumulate in your organs. Amyloid buildup often affects the kidneys, damaging their filtering system.
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Risk factors of Nephrotic syndrome

Factors that may increase your risk of nephrotic syndrome include : -

  • Your sex : - Nephrotic syndrome affects men more often than it does women.

  • Other medical conditions : - The following medical conditions increase your risk of developing nephrotic syndrome: diabetes, lupus, amyloidosis, minimal change disease and other kidney disease.

Tests and diagnosis of Nephrotic syndrome

If your doctor suspects nephrotic syndrome, he or she may recommend the following tests : -

  • Urine tests : - A urinalysis will show large amounts of protein in your urine if you have nephrotic syndrome. Fats also may be present in your urine.

  • Blood tests : - If you have nephrotic syndrome, a blood test may show low levels of the protein albumin (hypoalbuminemia) specifically and decreased levels of blood protein overall. Loss of blood protein may cause an increase in blood cholesterol and blood triglycerides. Serum creatinine and blood urea also may be measured to assess your overall kidney function.

  • Kidney biopsy : - A kidney biopsy may be necessary to confirm a diagnosis of the renal cause of nephrotic syndrome. This procedure involves using a special biopsy needle to extract small pieces of kidney tissue under local anesthesia for microscopic examination to search for glomeruli damage. Sometimes special stains of the kidney tissue or special studies, such as electron microscopy, also are necessary for diagnosis. If so, tissue diagnosis may take longer.

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Complications of Nephrotic syndrome

Possible complications of nephrotic syndrome include : -

  • Blood clots : - The inability of the glomeruli to filter blood properly can lead to loss of blood proteins that help prevent clotting. This increases your risk of developing a blood clot (thrombus) in your veins.

  • High blood cholesterol and elevated blood triglycerides : - When your blood level of the protein albumin falls, your liver makes more albumin. At the same time, your liver releases more cholesterol and triglycerides.

  • Poor nutrition : - Loss of too much blood protein can result in malnutrition. This can lead to weight loss, but it may be masked by edema.

  • High blood pressure : - Damage to your glomeruli and the resulting buildup of wastes in your bloodstream (uremia) can raise your blood pressure.

  • Acute kidney failure : - If your kidneys lose their ability to filter blood due to damage to the glomeruli, waste products may build up quickly in your blood. If this happens, you may need emergency dialysis - an artificial means of removing extra fluids and waste from your blood - typically with an artificial kidney machine (dialyzer).

  • Chronic kidney failure : - Nephrotic syndrome may cause your kidneys to gradually lose their function over time. Kidney function at less than 10 percent to 15 percent of normal capacity is considered end-stage kidney disease, which usually requires dialysis or a kidney transplant.

  • Infection : - Although it's not clear why, people who have nephrotic syndrome are at an increased risk of infection, such as pneumonia.
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Treatments and drugs for Nephrotic syndrome

Treatment for nephrotic syndrome involves treating the underlying medical condition. In addition, your doctor may prescribe an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) to reduce the amount of protein in your urine and prevent kidney disease from getting worse.

Depending on your situation, your doctor may also prescribe one or more of the following medications to help control signs and symptoms or complications of nephrotic syndrome : -

  • Diuretics, such as thiazide diuretics, furosemide (Lasix) or spironolactone, to increase your kidneys' output of water and sodium and control edema

  • Statins, such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) or simvastatin (Zocor), to lower blood cholesterol

  • Blood thinners (anticoagulants), such as heparin or warfarin (Coumadin), which decrease your blood's ability to clot and reduce your risk of developing blood clots

  • Immunosuppressive medications, such as corticosteroids, to decrease the inflammation that accompanies kidney disorders, such as membranous nephropathy

  • Antibiotics to control infection

Prevention of Nephrotic syndrome

Prompt treatment of medical conditions that can lead to nephrotic syndrome, such as diabetes, lupus, kidney disease and amyloidosis, may prevent some cases of nephrotic syndrome.

Lifestyle and home remedies for Nephrotic syndrome

Your doctor may recommend changes in your diet. He or she may refer you to a dietitian to discuss diet changes. You may need to : -

  • Limit your salt intake to help minimize fluid retention and swelling and to reduce your blood pressure
  • Modify your diet to decrease your cholesterol and triglyceride levels
  • Take vitamin D supplements

Talk with your doctor or your dietitian about what's right for you.

The list of of Nephrology Hospitals in India is as follows : -

Apollo Hospitals Bangalore Apollo Hospitals, Bangalore, India
Apollo Hospital Chennai Apollo Hospital, Chennai, India
Apollo Hospitals Hyderabad Apollo Hospitals, Hyderabad, India
Apollo Hospitals Delhi Indraprastha Apollo Hospital, Delhi, India
Apollo Hospitals Kolkata Apollo Gleneagles Hospital, Kolkata, India
Apollo Hospital, Goa, India Apollo Hospital, Goa, India
Wockhardt Hospital Bangalore India Wockhardt Hospital, Bangalore India
Wockhardt Hospital hyderabad, India Wockhardt Hospital, hyderabad, India
Wockhardt Hospital Mumbai, India Wockhardt Hospital, Mumbai, India
Wockhardt Hospital and Kidney Institute, Kolkata, India Wockhardt Hospital and Kidney Institute, Kolkata, India
Fortis Hospital, Delhi, India Fortis Hospital, Delhi, India
Fortis Hospital Mohali, India Fortis Hospital, Mohali, India
Fortis Hospital Noida, India Fortis Hospital, Noida, India
Manipal Hospital, Bangalore, India Manipal Hospital, Bangalore, India
Artemis Hospital, Gurgaon ( Delhi ) , India Artemis Hospital, Gurgaon ( Delhi ) , India
Max Super Specialty hospital,  Delhi, India Max Super Specialty hospital, Delhi, India
BGS Global Hospital Bangalore, India BGS Global Hospital, Bangalore, India
BGS Global Hospital Chennai, India BGS Global Hospital, Chennai, India
BGS Global Hospital Hyderabad, India BGS Global Hospital, Hyderabad, India

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