From the Guidelines
The main symptoms of a child with nephrotic syndrome include significant swelling (edema), particularly around the eyes, face, abdomen, and legs; foamy or bubbly urine due to protein leakage; decreased urination; weight gain from fluid retention; fatigue; and loss of appetite. These symptoms occur because the kidneys' filtering units (glomeruli) become damaged, allowing large amounts of protein (primarily albumin) to leak into the urine. When blood albumin levels drop, fluid shifts from blood vessels into surrounding tissues, causing the characteristic swelling. Children may also develop complications like infections due to lost immune proteins, blood clots from altered clotting factors, and high cholesterol levels.
Key Symptoms
- Significant swelling (edema) around the eyes, face, abdomen, and legs
- Foamy or bubbly urine due to protein leakage
- Decreased urination
- Weight gain from fluid retention
- Fatigue
- Loss of appetite According to the KDIGO 2021 guideline for the management of glomerular diseases 1, the treatment approach for nephrotic syndrome in children involves the use of glucocorticoids, such as prednisone, as the initial therapy. The Ibadan consensus statement 1 also recommends the use of prednisone as the initial treatment for idiopathic childhood nephrotic syndrome.
Treatment Approach
- Glucocorticoids, such as prednisone, as the initial therapy
- Sodium restriction and careful fluid management during episodes
- Additional immunosuppressive medications may be required for relapses or steroid-dependent cases It is essential for parents to seek immediate medical attention if their child shows these symptoms, as early treatment can induce remission in most cases. The management of idiopathic childhood nephrotic syndrome in sub-Saharan Africa, as outlined in the Ibadan consensus statement 1, emphasizes the importance of prompt treatment and careful management to prevent complications and improve outcomes.
From the Research
Main Symptoms of Nephrotic Syndrome (NS) in Children
The main symptoms of Nephrotic Syndrome (NS) in children are not explicitly stated in the provided studies. However, the studies discuss the treatment and management of NS, which can be used to infer the symptoms.
- The studies mention that NS is characterized by a significant loss of protein in the urine, leading to low levels of albumin in the blood 2, 3, 4, 5, 6.
- The symptoms of NS may include swelling, particularly in the face, legs, and feet, due to the buildup of fluid in the body 2, 3.
- Other possible symptoms of NS may include fatigue, weight gain, and foamy urine 2, 3.
Treatment and Management of NS
The treatment and management of NS are discussed in detail in the provided studies.
- The studies suggest that corticosteroids, such as prednisone, are the primary treatment for NS, with most patients responding to treatment within 4 weeks 2, 3.
- However, some patients may experience relapses or become steroid-dependent, requiring additional treatment with immunosuppressive medications 2, 3, 4, 5.
- The studies also discuss the use of cyclophosphamide, rituximab, and other medications in the treatment of NS, particularly in patients who do not respond to corticosteroids or experience frequent relapses 4, 5, 6.