Nephrotic syndrome is a group of symptoms including protein in the urine (more than 3.5 grams per day), low blood protein levels, high cholesterol levels, and swelling. The urine may also contain fat, which can be seen under the microscope.

Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.

The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.

This condition can also occur as a result of infection, use of certain drugs, cancer, genetic disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis.

It can accompany kidney disorders such as glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.

Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. This disorder occurs slightly more often in males than females.

• Swelling (edema )
  • general
  • around the eyes
  • in the extremities, especially the feet and ankles
• Swollen abdomen
• Facial swelling
• Foamy appearance of the urine
• Weight gain (unintentional) from fluid retention
• Poor appetite
• High blood pressure

Physical examination can detect some symptoms. Other symptoms and signs of causative disorders can also be found with examination.

Urinalysis reveals large amounts of urine protein. Fats are often also present in the urine.

Tests to rule out various causes may include the following:

• Glucose tolerance test
• Antinuclear antibody
• Rheumatoid factor
• Cryoglobulins
• Complement levels
• Hepatitis B and C antibodies
• VDRL serology
• Serum protein electrophoresis
• Kidney biopsy

• Urinary casts
• Triglyceride
• Protein electrophoresis - urine
• Serum iron
• Cholesterol
• Albumin