Nephrotic syndrome in children


Nephrotic syndrome in children is a kidney disorder. Nephrotic syndrome causes:-
  • Heavy proteinuria – Huge quantity of protein in the urine
  • Hypoalbuminemia – Low blood protein levels
  • Edema – Swelling, mostly observed around the eyes, ankles, and abdomen
  • Hyperlipidemia – High levels of cholesterol

Nephrotic syndrome is caused because the filtering system of the kidney has been damaged. The kidney’s filtering units known as glomeruli become faulty, due to which protein is lost in the urine. Nephrotic syndrome responds well to steroid treatment. In rare cases it might relapse. The treatment is successful in most cases and the child continues to live a normal life.

For expert pediatric care and treatment for Nephrotic Syndrome, book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

What are the various types of nephrotic syndrome seen in children?


There are both primary (idiopathic) and secondary causes for nephrotic syndrome.

1. Primary or Idiopathic Nephrotic Syndrome


Primary nephrotic syndrome originates directly from kidney diseases with no known external cause. It is common in children between ages 2–6. The various types of primary nephrotic syndrome are:-
  • Minimal Change Disease (MCD)
    • 80–90% of young children suffering from nephrotic syndrome have the MCD type.
    • If examined under a regular microscope the kidney filters (Glomeruli) appear normal.
    • Steroids are an excellent treatment for MCD and the child responds well to the treatment.
  • Focal Segmental Glomerulosclerosis (FSGS)
    • In this type of nephrotic syndrome the kidney filters have scars on them.
    • This type is resistant to steroids.
    • FSGS has the risk of progressing into a to chronic kidney disease
  • Membranous Nephropathy
    • This is a rare type of nephrotic syndrome.
    • The glomerular basement membrane thickens.

2. Secondary Nephrotic Syndrome


Secondary Nephrotic Syndrome is the result of another underlying disease or a condition. a form of nephrotic syndrome that occurs as a result of another underlying disease or condition such as :-
  • Infections
  • Systemic Diseases
  • Drugs and Toxins
  • Allergic Reactions or Vaccines (rare).

For expert pediatric care and treatment for Nephrotic Syndrome, book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

What are the causes for nephrotic syndrome in children?


There are both primary (idiopathic) and secondary causes for nephrotic syndrome. Below is the complete list of causes for nephrotic syndrome :-

1. Primary or Idiopathic Nephrotic Syndrome


The primary cause is damaged filters in the kidney which are known as Glomeruli. When examined under a microscope these filters appear normal.

2. Secondary Nephrotic Syndrome


Secondary nephrotic syndrome is caused by other underlying conditions:
Infections
  • HIV
  • Hepatitis B or C
  • Syphilis
  • Malaria

Systemic Diseases
  • Lupus (SLE)
  • Diabetes (rare in young children)
  • Henoch-Schönlein purpura

Drugs and Toxins
  • NSAIDS
  • Heavy metals
  • Antibiotics

Allergic Reactions or Vaccines
  • Insect stings
  • Immunizations
  • Allergens

For expert pediatric care and treatment for Nephrotic Syndrome, book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

What are the symptoms of nephrotic syndrome in children?


  • Edema (Swelling)
    Edema is the most common symptom most predominant around the eyes.
    Swelling could also spread to ankles, feet, abdomen, and genitals
  • Foamy Urine
    Due to the high levels of protein in the urine the urine has a frothy appearance
  • Decreased Urine Output
    The fluid retains in the body due to which the child passes less than normal urine.
  • Weight Gain
    The child gains weight due to the fluid retention. The weight gain is not due to fat or muscle increase.
  • Fatigue and Weakness
    The child get tired very quickly due to low protein levels in the blood
  • Loss of Appetite
    Cost due to abdominal swelling.
    Discomfort in the abdomen.
  • Pale Skin
  • The immunoglobulins in the urine are lost in the urine so the child has an increased risk of infections
  • High Cholesterol Levels

For expert pediatric care and treatment for Nephrotic Syndrome, book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

When should a child get immediate medical attention for nephrotic syndrome?


If a child is exhibiting any of the following conditions please get immediate medical care.

Infections


Nephrotic syndrome child the protective proteins are lost in the urine. The child immunity is also less because the steroids used in the treatment are Immunosuppressive. Hence a child is at a higher risk of infections. So take the child to doctor if:-
  • High Fever
  • Severe or sudden abdominal pain.
  • Cellulitis – Red, warm, or swollen areas
  • Pneumonia – Difficulty in breathing or continuous or continuously coughing
  • Sepsis – Fatigue or confusion
  • Meningitis – Headache along with vomiting

Dehydration

  • Severe weakness and lethargy
  • Sunken eyes and dry mouth.
  • Clammy and cold skin
  • Rapid breathing heartbeat

Breathing issues

  • Gasping for breath or fast breathing
  • Swelling and pain in the face, eyes, or abdomen. This could indicate fluid around the lungs.

Thrombosis – Signs of a Blood Clot


Clotting is one of the most challenging complications for a kid with nephrotic syndrome.
  • If the kid has fallen and bruised themselves please observe if the blood has clotted.
  • Child is continuously bleeding please seek medical assistance.

No Urine Output

  • Could be a possible indication for kidney failure.

For expert pediatric care and treatment for Nephrotic Syndrome, book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

How is nephrotic syndrome diagnosed in children?


Nephrotic syndrome in children is diagnosed based on following process:-

1. Clinical Symptoms

  • Swelling (edema)
  • Weight gain
  • Fatigue or irritability
  • Decreased urine output
  • Frothy urine

2. Urine Tests


The urine test is the most critical test. The results are interpreted as follows:-
  • If there is ≥3+ protein on urine dipstick, or >40 mg/m²/hr on a timed urine sample it indicates Massive proteinuria.
  • The test could also reveal Microscopic hematuria or Lipiduria.

3. Blood Tests


Blood tests can assess the severity of the syndrome:-
  • Low serum albumin (<2.5 g/dL)
  • High cholesterol levels
  • Low kidney function or low total protein

4. Kidney Ultrasound

  • Ultrasound is done to assess the kidney size and structure and to rule out other anatomical issues.

5. Kidney Biopsy


Kidney biopsy is done only under the following conditions:-:
  • Steroid resistance
  • Relapsed nephrotic syndrome.
  • The kidney function is deteriorating.

For expert pediatric care and treatment for Nephrotic Syndrome, book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

What are the treatments for nephrotic syndrome in children?


The main treatments in children with nephrotic syndrome are:-

Corticosteroids Steroids

  • This is the first line of treatment.
  • Prednisone or prednisolone are administered to stop the protein loss by reducing kidney inflammation
  • For the first 4–6 weeks High-dose daily steroids are given.
  • After that period the steroids are tapered to alternate-days and continued so for several weeks or months
  • Most children especially ages 1–10 respond well
  • Within 2–4 weeks of starting treatment the child shows improvement.

Edema Management

  • Mandatory salt restriction
  • If edema is severe edema or if the child has low sodium then fluid restrictions.
  • Diureticssed cautiously
  • Albumin infusions to control severe hypoalbuminemia and edema

Treatments and prevention of Infections

  • Antibiotics in case any of the infections are suspected
  • Be up to date with all the vaccinations.
  • Vaccines for Pneumococcal and influenza are recommended
  • Live vaccines such as MMR, varicella are delayed while on immunosuppressive therapy

Preventing Blood Clots

  • Anticoagulants – Blood thinners may be used in certain high-risk cases

Long-Term Monitoring

  • Even after the treatment is completed regular follow-up with pediatric nephrologist speed l should be continued.
  • Regular Urine testing must be fine until recommended by the doctor to catch relapses early
  • Monitor the following aspects in the child:-
    • Development and growth
    • Blood pressure
    • Kidney function
    • Any side effects due to medications

For expert pediatric care and treatment for Nephrotic Syndrome, book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

About Isha Specialty Clinics, Hyderabad


Isha Specialty Clinic is the best Hospital in Manikonda for your heart care and child care. For all your pediatric and newborn care we are a one stop solution. Our expert team of doctors and state of the art labs offer you comprehensive pediatric services. When you visit us you will experience the best paediatric care, children nutrition advice and best cardiologist treatment in Hyderabad. Isha Specialty clinics is located at convenient location in Hyderabad Manikonda in the nearby Gachibowli, Banjara Hills and Toli Chowki, Mehdipatnam, Narsingi, Alkapur township.

Our expert team of doctors


Dr. Swathy Talishetty – MBBS (Osmania), MD (Niloufer) – Child and Newborn Specialist (Paediatric Doctor)


Dr. Swathy Talishetty is a top rated child care specialist. Dr.Swathy is an alumnus of Osmania Medical College where she completed her MBBS in 2007 and later on pursued her MD in Pediatrics from Niloufer Hospital in 2012. Dr Talishetty Swathi has specialized in:-
  • Newborn and infant care
  • Immunization
  • Growth and development monitoring
  • Preterm baby management
  • Childhood overweight management.

Dr. Swathy Talishetty’s compassionate approach, combined with her in-depth knowledge of pediatric nutrition, enables her to offer comprehensive care that addresses both medical and nutritional needs of children, ensuring their healthy growth and development. Get children treatment and pediatric nutrition consultation with Dr. Swathy Talishetty at Isha Speciality Clinics Manikonda, nearby Gachibowli and Narsingi areas in Hyderabad.

Dr. Nithin Annarapu – MBBS, MD – General Medicine, DM – Cardiology


Dr. Nithin Annarapu has more than a decade of heart care experience. 18 Years Experience Overall (12 years as heart specialist). Dr. Nithin Annarapu Annarapu is an Interventional Cardiologist in Manikonda Hyderabad and has an experience of 18 years in heart treatment, surgeries and cardiac procedures. He has saved many lives with his excellent treatments for palpitations which are heart related. Dr. Nithin Annarapu is practicing at Isha Speciality Clinics Manikonda, near Gachibowli in Hyderabad. He completed MBBS from Siddhartha Medical College & Research in 2002, MD – General Medicine from Osmania Medical College, Hyderabad in 2006 and DM – Cardiology from Nizam Institute of Medical Sciences, Hyderabad in 2010.

Major Treatments at Isha Speciality Clinics


Pediatric Care

  • Newborn and infant care
  • Immunization
  • Growth and development monitoring
  • Preterm baby management
  • Childhood overweight management.

Heart treatment

  • Mitral valve replacement surgery
  • Heart valve replacement and repair
  • Coronary Angioplasty
  • Coronary Angiogram
  • Cardiac catheterization
  • Angioplasty

Pain treatment

  • Thoracic epidural injections
  • Cervical epidural injections
  • Intraarticular joint injections
  • Nerve Block
  • Spinal Cord Stimulation Therapy
  • Lumbar Epidural Injections

For expert pediatric care and treatment for acute bacterial infections , book a consultation today at Isha Specialty Clinic, Hyderabad (Call: 96760 70203).

For emergency care or appointments, contact Dr. Swathi Talishetty at Isha Speciality Clinic, Manikonda – Hyderabad at 96760 7020. Book an appointment today for expert pediatric care.

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