Diseases of the Urinogenital System - Nephrosis

The nephrotic syndrome , commonly referred to as nephrosis , is a disease in which abnormal amounts of protein in the form of albumin are lost in the urine. Albumin consists of microscopic particles of protein present in the blood. These particles are important in maintaining the proper volume of fluids in the body, and they have other complicated functions as well. The loss of albumin in the urine affects the amount that remains in the blood, and it is this imbalance, together with other body changes, that results in the retention of excess fluid in the tissues, thus causing facial puffiness and swelling of the legs.

The disease is caused by damage to the glomeruli, but at the present time the exact nature of the damage is uncertain. It may be caused by an allergic reaction, by inflammation, or it may be a complication of diabetes. The nephrotic syndrome may also appear because of blood clots in the veins that drain the kidneys.

Although the disease is more common among children than among adults, it may affect a person of any age. The main symptom is painless swelling of the face, legs, and sometimes of the entire body. There is also loss of appetite, a tired, rundown feeling, and sometimes abdominal pain, vomiting, and diarrhea.

Recovery from nephrosis varies with age. More than 50 percent of child patients are completely free of kidney ailments after the first attack. Adults are more likely to develop some impairment of kidney function, or the disease may become chronic, with accompanying high blood pressure. In some people, protein loss may continue over the years, although the kidneys function in an apparently normal manner without any visible symptoms.

Treatment

Treatment of the nephrotic syndrome has been greatly helped by the use of the adrenal hormones known as steroids . The treatment is effective for about two-thirds of child patients and for about one-fourth to one-third of adults. Some patients may relapse after therapy is completed, sometimes years after such therapy has been discontinued. For this reason, steroids are sometimes continued after initial treatment but in reduced dosage, to avoid some of the unpleasant side effects such as acne and facial swelling.

Unlike the dietary treatment for uremia, a high protein diet is used with nephrotic patients so that the protein loss can be replaced. Salt intake is usually restricted because salt contributes to fluid retention and may cause high blood pressure or heart failure. If fluid retention doesn't respond to steroid treatment, other medicines called diuretics , which increase urinary output, are used.

Anyone with unusual swelling of the face, limbs, or abdomen should see a physician promptly. Even though the swelling is painless, it may be the first sign of the onset of a serious kidney problem.