Nephrosis

Nephrosis, also known as nephrotic syndrome, is a kidney disorder characterized by a group of symptoms indicating kidney damage, particularly affecting the glomeruli. These symptoms typically include proteinuria (excess protein in the urine), hypoalbuminemia (low levels of albumin in the blood), edema (swelling, particularly in the ankles, feet, and around the eyes), and hyperlipidemia (high levels of lipids, such as cholesterol and triglycerides, in the blood).

The underlying cause of nephrosis is often damage to the glomeruli, the filtering units of the kidneys. This damage allows protein, normally retained in the bloodstream, to leak into the urine. This loss of protein, especially albumin, leads to a decrease in blood albumin levels (hypoalbuminemia). The liver, in an attempt to compensate for the loss of albumin, may increase the production of lipids, leading to hyperlipidemia. The reduced protein in the blood also disrupts fluid balance, leading to fluid retention and edema.

Nephrosis can be caused by a variety of underlying conditions, including but not limited to:

• Minimal change disease: A common cause in children, often responding well to steroid treatment. Glomeruli appear normal under a regular microscope.
• Focal segmental glomerulosclerosis (FSGS): A scarring of some glomeruli, which may progress to kidney failure.
• Membranous nephropathy: Thickening of the glomerular basement membrane due to antibody deposits.
• Diabetic nephropathy: Kidney damage caused by diabetes.
• Lupus nephritis: Kidney inflammation caused by systemic lupus erythematosus (SLE).
• Amyloidosis: Deposition of abnormal proteins (amyloid) in the kidneys.

Diagnosis typically involves blood and urine tests to measure protein levels, albumin levels, lipid levels, and kidney function. A kidney biopsy may be performed to determine the specific cause of the glomerular damage.

Treatment focuses on managing symptoms and addressing the underlying cause. Common treatments include:

• Medications to reduce protein loss: ACE inhibitors or ARBs are often used to lower blood pressure and reduce proteinuria.
• Diuretics: Used to reduce edema.
• Statins: Used to lower cholesterol levels.
• Immunosuppressants: Used in cases caused by autoimmune diseases.
• Dietary changes: Including reducing salt intake and limiting protein intake (although protein intake recommendations vary based on the individual's condition).

The prognosis for nephrosis varies depending on the underlying cause and the individual's response to treatment. Some individuals experience remission, while others may develop chronic kidney disease and eventually require dialysis or kidney transplantation. Regular monitoring and management are essential to prevent complications and improve long-term outcomes.