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Am Fam Physician. 2016;93(6):online

See related article on nephrotic syndrome

What is nephrotic syndrome?

Your kidneys filter out toxins and clean waste from your blood. If you have nephrotic (nef-RAH-tik) syndrome, or NS for short, your kidneys can't do this right.

What are the symptoms?

Your legs can swell over a few weeks or months, which may also make you gain weight. But most leg swelling is caused by something else. Sometimes the swelling from NS is severe. You may feel tired and have a lot of protein in your urine.

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. NS can also be caused by another disease, most often diabetes or lupus. Taking some medicines, such as anti-inflammatory drugs, can also cause it.

How do I know if I have it?

Your doctor will measure the protein in your urine and blood. He or she may do blood tests for diseases that might cause NS. 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 stay in the hospital for at least a few days. Your doctor may tell you to eat less salt or give you diuretics (also called water pills). You may also need medicines to reduce swelling and the inflammation in your kidneys. Some people with NS are more likely to get blood clots, so your doctor may also give you medicine to thin your blood.

Can it come back after being treated?

The swelling usually gets better after you take diuretics or other medicines. But the swelling can continue for years and you 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?

Your doctor

American Kidney Fund

National Institute of Diabetes and Digestive and Kidney Diseases

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