Nephrotic Syndrome

Nephrotic (neh FRAH tik) syndrome happens when protein passes from the kidneys into the urine through tiny filters in the kidneys. When this happens, there is too little protein in the blood.

The cause of this is not known. There is no known cure, but the symptoms can be managed with medicine.

Symptoms

You may notice swelling around your child’s eyes, face, ankles or feet especially first thing in the morning.

Diagnosis

Your child’s doctor may need to do a few tests to find out if your child has nephrotic syndrome.

• The doctor will test a sample of his or her urine for protein.
• Your child will have blood tests.
• The doctor may request other tests if needed.

Treatment

The most common treatment is the medicine prednisone. Prednisone is a steroid and helps to stop protein leaking into your child’s urine. Sometimes, another medicine like Lasix can help to get rid of the extra fluid. A low salt diet can help keep fluid from building up, too. Your child should eat a healthy, well-balanced diet.

What to Watch for At Home

• Check for puffiness around your child’s eyes, especially in the morning.
• Watch for swelling of his or her face, feet or abdomen.
• Check his first morning urine for protein.
• Check your child’s urine protein every morning during initial treatment and when he has any swelling or other illness. We will show you how to test the urine for protein. Testing the urine for protein will tell us if the condition has returned.
• When your child is on steroid treatment, call the clinic when his urine protein is negative or trace for 3 days in a row.

Medications

• Give your child the prednisone as directed, with meals. Prednisone can cause
  • Increased appetite
  • Mood changes; he may be moody or irritable while taking the medicine  
  • Weight gain
• Weigh your child as directed and record his weight. Check the urine protein once weekly or as directed.
• If your school nurse or child care provider will be giving this medicine, ask for 2 labeled containers at the pharmacy.
• Get this prescription refilled at least 7 days before the last dose is given. This is very important.
• Be sure to tell the doctor if you are using any herbal remedies or over-the-counter medicines to treat your child. Some herbs and medicines can react with the medicine your child’s doctor has ordered and cause harm or make it less effective.
• Store all medicine out of the reach of children.

What to Do for Pain

• If your child has pain or discomfort you may give Tylenol®. His or her doctor will tell you how to give it and how much to give.
• Do not give aspirin, Motrin® or ibuprofen.

When to Call the Doctor

Call your child’s doctor if any of the following happens:

• Urine protein is 2+ or higher for 2 or more days
• Swelling or weight gain
• A fever of 100.5 °F or higher
• Shortness of breath
• Belly pain
• Any side effects that continue or are very bothersome

Most children outgrow nephrotic syndrome. If symptoms return, more treatment with prednisone or other medication will be needed.

Expect your child to have regular follow-up appointments with his doctor. The treatment is different for each child.

If you have any questions, be sure to ask the doctor or nurse.

Nephrotic Syndrome (PDF)

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