NEPHROSIS (Nephrotic Syndrome)
Nephrosis is a form of chronic kidney disease that begins in childhood. Nephrosis is characterized by protein in the urine, swelling of the skin and organs, and low protein and high cholesterol in the blood. Early stages of the disease involve only the kidneys, but late or complicated stages involve all body cells. Nephrosis usually occurs in children between ages 1 and 6 -- especially ages 2 and 3. It affects more boys than girls. Appropriate health care includes: physician's monitoring of general condition and medications; self-care after diagnosis.
SIGNS & SYMPTOMSFluid retention that appears first as puffy eyes and ankles, then as general puffiness of the child's skin, and eventually as a swollen abdomen.
Reduced urine production, sometimes to 20% of normal.
Loss of appetite.
General ill feeling.
Unknown. May be primary (of unknown cause) or may occur as a complication of other problems which affect kidney functions, such as diabetes, lupus erythematosus, glomerulonephritis, autoimmune disorders, serum sickness and other severe allergic disorders, a blood clot in the kidney, infections (especially of the skin), or congenital heart disease.
Family history of nephrosis (primary form only). The following may reactivate a childhood case: pregnancy, exposure to chemical toxins, and congestive heart failure.
PREVENTING COMPLICATIONS OR RECURRENCEObtain prompt medical treatment for your child for any causes listed, especially skin and throat infections.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory studies, such as urinalysis and blood studies of protein and cholesterol.
Kidney disease that resembles chronic glomerulonephritis.
Increased susceptibility to infections.
PROBABLE OUTCOMENephrosis can't be cured or prevented. However, medication and diet can control swelling and reverse kidney abnormalities in many children.
Although symptoms usually disappear in 2 weeks with treatment, medication is continued for 6 to 8 weeks. Nephrosis can be arrested with treatment, but relapses are common and the treatment must be repeated. If kidney failure develops, dialysis or a kidney transplant can prolong your child's life.
HOME CAREDuring the acute phase:
Keep a record of the child's temperature each morning and evening.
Collect all urine the child passes during each 24 hours and record every amount.
Record all fluids the child consumes. Portions of the child's urine will be analyzed in the doctor's office.
MEDICATIONCortisone or immunosuppressive drugs to reduce kidney inflammation.
Diuretics, including potassium-saving diuretics, to reduce fluid retention.
Antibiotics to control infection.
See Medications section for information regarding medicines your doctor may prescribe.
Your doctor may prescribe:
Keep your child in bed (except for trips to the bathroom) until the edema (fluid retention) improves. After the swelling decreases, the child may be as mildly active as strength allows.
DIET & FLUIDSCook and serve the child's food without salt. Avoid serving prepared foods that contain salt. Include more protein than usual, such as fish, meat, eggs, and low-salt cheese.
You may need to restrict your child's fluid intake. Ask your doctor.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of nephrosis.
The following occurs during treatment: Severe headache; convulsion; extreme weakness; signs of infection, such as fever, sores on the skin, cough, or burning on urination; failure to pass 1 quart of urine in a 24-hour period; increased fluid retention; vomiting, diarrhea, or nausea.