Nephrotic syndrome causes your kidneys to release too much protein in your urine. Causes include kidney diseases that affect the tiny filters inside your kidneys. Symptoms include swelling, high amounts of protein in your urine and low amounts of protein in your blood. Treatment includes medications that address its underlying causes.
Nephrotic (neff-rot-ick) syndrome is a condition in which your kidneys release an excessive amount of protein (proteinuria) in your urine (pee).
Nephrotic syndrome usually results from a problem with your kidneys’ filters (glomeruli). Glomeruli (glo-mare-yoo-lye) are tiny blood vessels in your kidneys. They remove wastes and excess fluids from your blood and send them to your bladder as urine. Common waste products include nitrogen waste (urea), muscle waste (creatinine) and acids.
In healthy kidneys, the glomeruli filter out the waste products. They allow your blood to retain the cells and proteins your body needs to function regularly.
Damaged glomeruli allow blood proteins to leak into your pee, including albumin. If you have nephrotic syndrome, your damaged glomeruli allow three or more grams (g) of protein to leak into your pee over 24 hours. Three grams is a little heavier than a U.S. penny. It’s 20 times the amount of protein that healthy glomeruli allow.
Nephrotic syndrome is a serious condition. Without treatment, nephrotic syndrome can affect your life expectancy due to secondary complications.
Nephrotic syndrome can affect anyone. However, it’s most common in people with diabetes-related kidney disease, people who have allergies and people who have a biological family history of kidney disease with nephrotic syndrome.
Nephrotic syndrome is relatively rare.
Nephrotic syndrome occurs in about 1 in every 50,000 children each year. Most children receive a nephrotic syndrome diagnosis between the ages of 2 and 5. Boys and children assigned male at birth (AMAB) are about twice as likely to have nephrotic syndrome as girls or children assigned female at birth (AFAB).
It occurs in 3 in every 100,000 adults each year.
If you have nephrotic syndrome, losing different proteins may cause various problems.
Some proteins help prevent blood clots. When you lose those proteins in your pee, blood clots can form.
Immunoglobulins are proteins that help your immune system fight diseases and infection. When you lose immunoglobulins, you’re at a greater risk of general infections that affect different body systems, including:
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Common nephrotic syndrome symptoms include:
Another symptom of nephrotic syndrome is a loss of minerals and vitamins that are essential to your health and development, including calcium and vitamin D. In children with nephrotic syndrome, this may affect their growth. You may develop osteoporosis, which weakens your hair and nails.
The most common complications of nephrotic syndrome include:
Kidney diseases often damage your glomeruli. The diseases target your glomeruli, though healthcare providers and medical researchers aren’t sure why. Damaged glomeruli are the primary cause of nephrotic syndrome. These diseases include:
The following tests and procedures help diagnose nephrotic syndrome:
A urinalysis (urine test) examines the visual, chemical and microscopic aspects of your pee. Your healthcare provider may recommend a few different types of urinalysis tests.
During a dipstick test, you’ll pee into a special container at your healthcare provider’s office or a hospital. Then, a healthcare provider will place a strip of paper coated with special chemicals (dipstick) into the container. The dipstick will change color if there’s albumin in your pee.
If your healthcare provider needs a more precise measurement, they may recommend urine protein tests. Urine protein tests may include a single urine sample or a 24-hour collection of urine.
In a single urine sample, your container is sent to a lab. Lab technicians compare how much albumin and creatinine are in your pee (albumin-to-creatinine ratio). If your urine sample has more than 30 milligrams (mg) of albumin for each gram of creatinine, it may signal a problem.
In a 24-hour urine collection, your healthcare provider will give you a container to collect your pee from home. On the day of the test, you’ll:
You’ll then drop your sample off at your healthcare provider’s office or a lab. Lab technicians will only measure the amount of albumin in your sample.
During an albumin blood test, your healthcare provider will use a thin needle to withdraw a small amount of blood from a vein in your arm. The blood sample goes to a lab for testing. A low level of albumin or other proteins may indicate nephrotic syndrome.
Lab technicians may also test your blood cholesterol and blood triglyceride levels. Those levels may increase if your blood albumin level is low.
During a kidney biopsy, your healthcare provider will remove a small piece of your kidney tissue to examine at a lab under a microscope.
Your healthcare provider will first numb the area with a local anesthetic so you won’t feel any pain. They’ll also give you a light sedative to help you relax. Then, they’ll insert a needle through your skin and into your kidney to collect the tissue sample.
If you have diabetes and your healthcare provider suspects you have nephrotic syndrome, you likely won’t need a kidney biopsy. Your medical history, urine tests and blood tests are often enough to help them diagnose nephrotic syndrome as a result of your diabetes.
No, nephrotic syndrome isn’t curable. However, nephrotic syndrome often goes away in children once they reach their late teenage years or early 20s.
Treatment helps relieve your nephrotic syndrome symptoms and prevents further damage to your kidneys.
Nephrotic syndrome treatment includes addressing the underlying cause and taking steps to reduce high blood pressure, high cholesterol, swelling and infection risks. Treatment usually includes medications and changes to your diet.
Some blood pressure medications can slow down a kidney disease that causes nephrotic syndrome, including:
These medications reduce the pressure inside your glomeruli, which reduces albuminuria. Many people require two or more medications to regulate their blood pressure.
In addition to an ACE inhibitor or an ARB, your healthcare provider may recommend a diuretic. Diuretics help your kidneys remove fluid from your blood. Diuretics also help reduce blood pressure and swelling. Other medications that help lower your blood pressure include beta-blockers and calcium channel blockers.
To lower your cholesterol, your healthcare provider may recommend statin medications.
If you have nephrotic syndrome, it’s also a good idea to get a yearly influenza (flu) vaccine and a pneumococcal (new-ma-cah-cole) vaccine. A pneumococcal vaccine helps protect your body from a pneumococcus (new-ma-cah-cuss) bacterial infection. These bacteria may cause ear infections, strep throat, pneumonia and meningitis.
In some cases, your healthcare provider may recommend medications that help prevent blood clots (anticoagulants or blood thinners). If you have nephrotic syndrome, you’ll only take these medications if you develop a blood clot. They don’t prevent nephrotic syndrome or any symptoms of nephrotic syndrome.
Diet and nutrition don’t cause or prevent nephrotic syndrome in adults. However, if you have nephrotic syndrome, changes to your diet may help relieve some of your symptoms.
You can help reduce swelling by limiting the amount of sodium in your diet. Most sodium in your diet comes from salt. You can also help reduce swelling by drinking more fluids.
Reducing saturated fat and cholesterol in your diet can help manage hyperlipidemia. It’s a good idea to limit foods like full-fat dairy, red meat, processed meat, cheese, fried foods, baked goods and sweets.
The best way to manage your symptoms is to take your medications as prescribed by your healthcare provider. It’s also a good idea to maintain a diet with appropriate amounts of potassium and protein but low amounts of sodium, saturated fat and cholesterol.
It depends on the cause of your nephrotic syndrome. Some people may start to feel better a few days after treatment, while it may take others a few weeks or even months.
You can’t prevent nephrotic syndrome. However, you can improve the symptoms of nephrotic syndrome by treating its cause and making changes to your diet.
With proper diagnosis and treatment, the outcome for people with nephrotic syndrome is good. Most people respond well to treatment, and nephrotic syndrome often goes into remission.
If you have nephrotic syndrome as a child, it often goes away by your early adult years.
Contact your healthcare provider as soon as you notice any kidney symptoms that last longer than a few days, especially if your pee is foamy.
Nephrotic syndrome and nephritic syndrome are both conditions that affect your kidneys.
The primary feature of nephrotic syndrome is a large amount of protein in your blood.
The primary feature of nephritic system is inflammation, usually from an infection, vascular disease or degeneration.
Glomerulonephritis is also a type of kidney disease, and its symptoms are similar to nephrotic syndrome. However, your kidneys release more protein through your urine if you have nephrotic syndrome. You’ll lose more than 3.5 grams of protein if you have nephrotic syndrome. You’ll lose less than 3.5 grams of protein if you have glomerulonephritis.
Congenital nephrotic syndrome exists at birth. It usually causes permanent kidney failure between the ages of 2 and 8. It’s an inherited kidney disease, which means your parents passed it down to you.
A note from Cleveland Clinic
Nephrotic syndrome is a kidney disease that causes you to lose proteins in your pee. If you have nephrotic syndrome, you may have pain in your abdomen, foamy pee and a general feeling of illness. If you’ve had any of these symptoms for more than a few days, it’s a good idea to reach out to your healthcare provider. They can prescribe treatments that can help keep your kidneys healthy.
Last reviewed by a Cleveland Clinic medical professional on 11/23/2022.
Learn more about our editorial process.