Childhood Nephrotic Syndrome: Causes, Symptoms, Diagnosis, and Treatment

Childhood nephrotic syndrome is a kidney disorder that primarily affects children, especially between the ages of 1 and 10 years. It occurs when the kidneys’ filtering units, known as glomeruli, become damaged and allow large amounts of protein to leak into the urine. This loss of protein leads to swelling, frequent infections, and other health complications. Early diagnosis and proper treatment are essential to manage the condition and ensure normal growth and development in children.

What Causes Childhood Nephrotic Syndrome?

In most children, the exact cause of nephrotic syndrome is unknown. This is known as minimal change disease, which accounts for the majority of cases. Other causes may include focal segmental glomerulosclerosis (FSGS), membranous nephropathy, genetic disorders, infections, and immune-related conditions. Sometimes nephrotic syndrome can develop after viral infections or due to certain medications.

Common Signs and Symptoms

The most noticeable symptom of childhood nephrotic syndrome is swelling (edema). Swelling usually starts around the eyes, especially in the morning, and may later affect the legs, ankles, abdomen, and genital area. Other symptoms include frothy or foamy urine due to high protein levels, weight gain, fatigue, decreased appetite, and frequent infections. Some children may also have reduced urine output.

Diagnosis

Doctors diagnose nephrotic syndrome through urine and blood tests. A urine test shows high levels of protein, while blood tests often reveal low protein (albumin) levels and high cholesterol. In some cases, especially if the child does not respond to standard treatment, a kidney biopsy may be recommended to identify the exact type of kidney disease.

Treatment and Management

The mainstay of treatment for childhood nephrotic syndrome is corticosteroid therapy, which is effective in most children. Steroids help reduce protein leakage and control symptoms. Supportive treatments include diuretics to reduce swelling, antibiotics for infections, and medications to control blood pressure. A low-salt diet is usually advised to help manage fluid retention.

Some children may experience frequent relapses or become steroid-resistant. In such cases, alternative immunosuppressive medications may be required under specialist supervision. Regular follow-up is crucial to monitor kidney function, growth, and treatment side effects.

Prognosis and Long-Term Outlook

With proper treatment, most children with nephrotic syndrome achieve remission and lead normal lives. Although relapses are common, especially during infections, long-term kidney damage is rare in steroid-responsive cases. Early medical care, adherence to treatment, and parental awareness play a key role in positive outcomes.

Childhood nephrotic syndrome is a manageable kidney condition when diagnosed early and treated appropriately. With regular monitoring and timely care, affected children can maintain good health and normal development.

Author:

Prof. Dr. Azmeri Sultana

Senior Consultant - (Paediatric Nephrology)

Paediatrics

Evercare Hospital Dhaka