Nephrotic syndrome is a collection of symptoms that occur when the kidneys are damaged and cause a "leak" of protein into the urine. This syndrome can trigger a variety of problems, including swelling in body tissues and infections that are prone to occur. Nephrotic syndrome can be experienced by individuals from various backgrounds. It's just that, this condition is common in children under six years of age. Know everything about nephrotic syndrome in children.
Nephrotic syndrome in children, what is it like?
As in adults, nephrotic syndrome in children occurs when the small blood vessels in the kidneys, called the glomerulus, are damaged and do not function properly.
Under normal conditions, the glomerulus plays a role in filtering blood to remove waste and excess fluid. Excess metabolic waste and extra water are then excreted out of the body through urine. Proteins and other substances that the body still needs will remain in the bloodstream.
However, if the glomerulus is damaged and dysfunctioning in the case of nephrotic syndrome in children, the glomerulus cannot filter effectively so the protein will "leak" and enter the urine. One of the proteins that enter the urine is albumin. Albumin plays a role in drawing extra fluid from the body into the kidneys so that it can be excreted through urine.
If the child's body loses a lot of albumin in nephrotic syndrome, the body is swollen due to fluid buildup.
Nephrotic syndrome can occur in 1 in 50,000 children. Usually, nephrotic syndrome in children is diagnosed when he is 2-5 years old. Boys are more at risk of developing this syndrome than girls. Children with a family history who have allergies or come from Asia are more prone to develop nephrotic syndrome (although the cause is unknown).
Symptoms of the nephrotic syndrome in children
Nephrotic syndrome in children can cause several characteristic symptoms, including:
1. Edema
Edema is swelling in certain body parts due to fluid buildup. Swelling is most common in the legs, feet, or ankles. Swelling may also be seen on the hands or face, although it's rare.
2. Changes in urine
One of the symptoms of nephrotic syndrome in children related to urine is albuminuria. This condition occurs when the child's urine contains high levels of albumin (protein) due to damaged glomerulus. Children with nephrotic syndrome whose symptoms recur may also pass less urine.
3. Infection
Protein that leaks into the urine due to nephrotic syndrome makes children more susceptible to infection. The reason is, the protein contains antibodies which play a vital role in warding off infection.
4. Blood clots
Nephrotic syndrome in children causes the little one to lose protein which plays a role in preventing blood clots. The leaking protein can increase the risk of serious blood clots in the body.
5. Symptoms of the nephrotic syndrome in other children
In addition to the above symptoms, nephrotic syndrome in children will also cause the following symptoms:
- Fever and other signs of infection
- Fatigue
- Easy to get angry
- Loss of appetite
- The appearance of blood in the urine
- Diarrhea
- Blood pressure becomes high
Causes of the nephrotic syndrome in children
In many cases of nephrotic syndrome in children, the cause is unknown.
Many children with nephrotic syndrome have minimal change disease. This means that your little one's kidneys look normal or nearly normal when the tissue sample is examined through an ordinary microscope. However, using an electron microscope, changes in kidney tissue will be detected. The cause of this minimal change disease is unknown.
In some cases, nephrotic syndrome in children can result from kidney problems or other conditions, such as:
- Glomerulosclerosis, which is the presence of scar tissue on the glomerulus
- Glomerulonephritis or glomerular inflammation
- Infections such as HIV infection or hepatitis
- Lupus
- Diabetes
- Sickle cell anemia
- Certain types of cancer, such as leukemia, multiple myeloma, or lymphoma (rare)
Some children with this condition develop congenital nephrotic syndrome. Nephrotic syndrome in this child begins to appear at 3 months in the early life of the little one.
Congenital nephrotic syndrome can be caused by inherited gene disorders or infections that occur shortly after the birth of the child. Children with congenital nephrotic syndrome also usually need a kidney transplant.
Management of nephrotic syndrome in children
The main treatment for nephrotic syndrome in children is corticosteroids. However, if your child experiences significant side effects, the doctor may prescribe another medication.
1. Corticosteroids
Initially, children with nephrotic syndrome are usually prescribed steroid prednisolone for 4 weeks. After that, the doctor will adjust the dosage to be smaller every two days for the next 4 weeks. This strategy can stop the leakage of protein from the child's kidneys into the urine.
Most children with nephrotic syndrome can respond to prednisolone well. Leakage of protein into the urine can be treated and the swelling in the body can reduce in a few weeks. This period is called the remission period.
2. Diuretic drugs
In addition to corticosteroids, your doctor may also prescribe them diuretics or water pills to treat nephrotic syndrome and reduce swelling in children. Diuretics can help reduce the buildup of fluid in your little one and increase the volume of urine production.
3. Penicillin
Penicillin is an antibiotic. The doctor may prescribe penicillin during the relapsing period to reduce the chance of infection in the child.
Caring for children with nephrotic syndrome
Nephrotic syndrome in children certainly causes deep concern for parents. Luckily, however, many cases of nephrotic syndrome can be handled well by a doctor as long as you pay attention to the symptoms.
Children with nephrotic syndrome will still need to continue their normal activities, such as going to school and playing with their friends. In other words, nephrotic syndrome in children does not need to make them feel different so you need to "treat" it like any other child.
However, your doctor may recommend a low-salt diet for your child. This diet can reduce the swelling that is typical of nephrotic syndrome. You will also need to check your child's urine regularly as protein in the urine is one of the main signs of a recurrence of nephrotic syndrome.
Can nephrotic syndrome cause death?
Nephrotic syndrome in children can lead to death because of the risk of complications. Complications of nephrotic syndrome include severe infection, the formation of blood clots, malnutrition, and kidney failure. In some children with congenital nephrotic syndrome, doctors will immediately perform actions such as a kidney transplant.
