Nephrotic Syndrome (Children)

Nephrotic Syndrome (Children) - What it is

What is Childhood Nephrotic Syndrome?

Childhood nephrotic syndrome is a kidney condition that results from abnormal leakage of protein in the urine.

What Causes Nephrotic Syndrome?

There are various forms of nephrotic syndrome in children and the most common is Minimal Change Disease. Its underlying cause is still unknown. Lifestyle changes or food are not known to cause Nephrotic Syndrome.

It is seen more frequently in boys and tends to occur in children between 2 to 6 years.

Nephrotic Syndrome (Children) - Symptoms

How do I know my child has Nephrotic Syndrome?

Your child will have gradual weight gain associated with swelling around the eyes, face, tummy and legs.

These are the consequences of protein loss in the urine (proteinuria) and subsequent water retention in tissues.

How do we confirm that your child has Nephrotic Syndrome?

Blood tests will be done to measure the level of protein (albumin) in the blood and assess kidney function.

Urine will be collected to check for the presence of protein.

Nephrotic Syndrome (Children) - How to prevent?

Nephrotic Syndrome (Children) - Causes and Risk Factors

Nephrotic Syndrome (Children) - Diagnosis

Nephrotic Syndrome (Children) - Treatments

How is Nephrotic Syndrome treated?

1) Medication:

Your child will be started on a drug called Prednisolone for treatment of Nephrotic Syndrome. Treatment is for a minimum duration of 2 months from first diagnosis.

More than 90% of children will have resolution of protein in the urine and body swelling with the treatment (Steroid Responsive Nephrotic Syndrome) and this carries an excellent outcome in the vast majority who will continue to have normal kidney function and normal growth.

Please do not adjust or discontinue the Prednisolone as sudden change of dose can pose significant medical risk to your child.

Prednisolone has potential side effects like any other drugs. The side effects are more common with higher doses and longer duration of use.

Some of the common side effects are:

Increased appetite and weight gain
Mood swings and hyperactivity
Increased risk of infection

Your doctor will discuss the other side effect(s) with you.

2) Monitoring:

You will be asked to check your child’s urine for protein daily and to record the results in the Nephrotic Diary.

These will help you and your doctor to monitor your child’s progress and to detect a relapse early.

When your child starts to respond to treatment, he/she will pass large amounts of urine with gradual weight loss and resolution of the body swelling. His/her urine protein level will gradually decrease to negative.

A renal specialty nurse will guide you through the technique of using a test strip (urine dipstick) to test for the presence of protein on an early morning urine sample (see appendix).

Nephrotic Syndrome (Children) - Preparing for surgery

Nephrotic Syndrome (Children) - Post-surgery care

Nephrotic Syndrome (Children) - Other Information

What is relapse of Nephrotic Syndrome?

A relapse is the reappearance of proteinuria 3+ for >3 consecutive days or proteinuria with or without evidence of body swelling.

Over 70% of patients may relapse. Your child may be restarted on Prednisolone when he/she is in relapse.

How can I help my child after discharge from hospital?

Lifestyle:

Avoid high salt and high caloric food when on daily dose of prednisolone, particularly processed food, junk food, gravy and sauces.
Active daily lifestyle with no activity restriction when they are in remission (no proteinuria and no swelling) but avoid crowded area as there is increased risk of infection.
Fluid intake as per your doctor’s advice.

Monitoring:

Check your child’s urine with urine dipstick every morning (see appendix).
Record the urine protein result on Nephrotic Diary every day.
Record your child’s condition on the comments column available, if unwell eg. flu, diarrhoea etc.

Vaccinations:

Please consult your doctor when there is a need for vaccinations.

Overview

Kidney Biopsy (Children),

Prednisolone

Article contributed by Nephrology Service (Kidney Diseases), KK Women's and Children's Hospital

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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