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Am Fam Physician. 2009;80(10):1136

See related article on nephrotic syndrome.

What is nephrotic syndrome?

Nephrotic (nef-RAH-tik) syndrome (NS) is when your kidneys don't filter out toxic substances and waste from your blood.

What are the symptoms?

Your legs can swell over a few weeks or months, which may also make you gain weight. You may feel tired, and you can have large amounts of protein in your urine. Some people get fluid around the lungs, but they usually don't get short of breath.

What causes it?

NS is usually caused by inflammation in your kidneys that does not have a definite cause. It may also run in families. In some people, NS is caused by another disease, most often diabetes. Some medicines, such as anti-inflammatory drugs, can also cause it.

How do I know if I have it?

Your doctor will measure the amount of protein in your urine and blood to see if the swelling in your legs is from NS or something else. He or she may do blood tests for diabetes, lupus, infections, or other causes. Your doctor may also look at a small piece of your kidney under a microscope (this is called a biopsy).

How is it treated?

You will probably need to be treated in the hospital for at least a few days. You may need to eat less salt. Your doctor may also give you diuretics (also called water pills). Some blood pressure medicines can reduce swelling, and steroid medicines can reduce the inflammation in your kidneys. Some people with NS are more likely to get blood clots, so your doctor may also prescribe blood-thinning medicines.

Can NS come back after being treated?

The swelling usually gets better after taking diuretics or other medicines. But you may have swelling for years and may need to keep taking medicine every day. It is important for you to keep seeing your doctor to make sure that your kidneys are not being damaged.

Where can I get more information?

American Kidney Fund

National Institute of Diabetes and Digestive and Kidney Diseases

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