Nephrotic syndrome is a group of symptoms which actually indicates an ongoing kidney damage or failure. Both children and adults may encounter this condition. However, nephrotic syndrome in children has different manifestations than that of an adult.
The kidney is a bean-shaped organ which helps the body filter waste products in the form of creatinine and urea. In addition, kidneys facilitate the excretion of excess water and salt from food and drinks. If a person has healthy kidneys, the waste products are filtered and evacuated efficiently and protein is retained in the blood.
With unhealthy kidneys, the waste materials may not be filtered well and may spread all throughout the body through the blood stream. In addition, excess water may not be excreted and may seep through the underlying tissues, thus, swelling occurs.
Nephrotic syndrome in children may occur at any age of a child. However, this condition is more prevalent in kids between 1 and ½ to 5 years old. Also, the syndrome is commonly seen in boys than in girls.
Nephrotic syndrome in children is characterized by the following symptoms: elevated protein levels in the urine (proteinuria), lesser periods of urination, weight gain, edema (swelling) and low levels of protein in the blood (hypoproteinemia).
Nephrotic syndrome is not in itself a disease; rather, it can be an initial sign that damage is ongoing in the kidney’s filtering units called glomeruli.
The condition is usually diagnosed through urine and blood samples. A urine sample is usually tested for the presence of protein. A chemically-treated strip is usually dipped in the urine. If the sample has an elevated level of protein molecules, the strip usually changes color. In blood samples, an extracted blood is tested for BUN (blood urea nitrogen) and Creatinine levels.
If the kidneys are filtering well, the levels of BUN and Creatinine are within normal limits. However, if kidney deterioration or damage is occurring, the BUN and Creatinine levels are markedly high.
Several conditions are associated with nephrotic syndrome in children. Among others, the minimal change disease is the most common. The condition is called minimal change disease because the kidneys have normal or nearly normal biopsy results.
Some children never get a relapse and goes on without any symptoms of nephrotic syndrome. However, in cases of relapse, a cytotoxic agent may be utilized in the form of Cyclophosphamide or Chlorambucil.
Twenty percent of children with nephrotic syndrome usually reveal scarring in the kidney biopsy results. The scarring is usually a result of two conditions namely FSGS (Focal Segmental Glomerulosclerosis) and MPGN (Membranoproliferative Glomerulonephritis).
In addition to Prednisone, Cytotoxic agents and ACE inhibitors are added to the treatment regimen of children with these conditions.
Congenital nephropathy is a very rare occurrence which causes nephrotic syndrome in children. Basically, the most common form is the congenital nephropathy Finnish type (CNF), wherein the gene is inherited from both parents (autosomal recessive trait).
Another congenital anomaly which is discovered in the first months of life is the DMS (DiffusedMesangial Sclerosis).Unlike CNF, the etiology of DMS is not clearly understood but it is believed to be genetic in nature. Since medicines are not highly effective for children with congenital nephropathy, kidney transplantation is the treatment of choice.
To keep the child’s normal body functions, albumin infusions are usually done. In addition, antibiotics are given at the first sign of infection. Because children with this kind of condition need supplemental nutrition, some may even be given tube feedings.
Recently, research studies have been conducted in order to develop safer and more effective interventions for nephrotic syndrome. Some clinical trials have been conducted which promise lesser side effects. However, these studies still need to be clinically proven and approved by the authorized body or organization.