Symptoms

Many people who have nephrotic syndrome do not have any noticeable physical symptoms. When symptoms are present, they can include:

• Swelling in the tissues around the eyes (periorbital edema) or in the feet or ankles (peripheral edema). This is the most common early symptom of nephrotic syndrome in both children and adults.
• Shortness of breath caused by fluid buildup in the lungs (pulmonary edema).
  • Adults older than 65 may be misdiagnosed with heart failure.
  • Children are often thought to have allergies.
• Dry skin.
• Swelling of the scrotum (scrotal edema), which may cause a cord in the testicles to twist (testicular torsion).

Signs of nephrotic syndrome in blood and urine tests can include:

• Protein in the urine (proteinuria).
• Low protein (albumin) in the blood.
• High cholesterol and triglyceride levels.
• Low blood levels of iron and vitamin D.

What Happens

Nephrotic syndrome occurs when the kidneys are not working properly. Healthy kidneys filter out excess water, salts, and other things from the blood in our body. Large amounts of protein and minerals are lost through urine when kidneys have damaged filters. The body is left without enough protein to soak up water. As a result, the water moves from the blood supply into body tissues. This causes swelling in the tissues where the water pools.

The most common areas of swelling are in the face around the eyes and in the ankles and feet. Fluid can also collect in the lungs, making it difficult to breathe.

Complications of nephrotic syndrome can include:

• Infection, such as peritonitis, cellulitis, and sepsis.
• Blood clots in veins (deep vein thrombosis) or in the lungs (pulmonary embolus).
• Blood clots in the arteries (acute arterial thrombosis). A blood clot in an artery (arterial embolus) can block blood flow to your arm or leg.
• Increased cholesterol or triglyceride levels in the blood (hyperlipidemia).
• Poor kidney function leading to chronic kidney disease. For more information, see the topic Chronic Kidney Disease.
• Growth delays in children, which can result in shorter height as an adult.

Acute nephrotic syndrome can develop quickly over a few days to a few weeks, causing edema (swelling) and possibly kidney failure.

If another severe medical condition (such as diabetes or high blood pressure) is causing nephrotic syndrome, you may have complications from the other condition also.

Most children who have nephrotic syndrome do well with treatment and have a normal life expectancy.

Complete recovery is possible. Doctors define complete recovery as living without symptoms or treatment for more than 2 years.