How Do We Diagnose Nephrotic Syndrome?

We diagnose nephrotic syndrome in 3 ways, which are:

  • A complete review of your child’s medical history
  • A physical exam by your child’s nephrologist (kidney doctor)
  • Diagnostic testing

There are 4 diagnostic tests, but your child will most likely not have all 4. We will talk with you about which tests are most appropriate. These tests are:

  • Urine testing to check for protein. We might test multiple samples of your child’s urine over a 24-hour period to get more exact measures of the protein.
  • Blood testing to see how well your child’s kidneys are working and to check cholesterol and albumin levels
  • An ultrasound of the kidneys to check the kidneys’ sizes and structures
  • A kidney biopsy, in which we remove a small sample of your child’s kidney and check it under a microscope. We do this only if your child’s nephrologist thinks it is needed.

How Do We Treat Nephrotic Syndrome?

We treat nephrotic syndrome in 3 ways:

  • With a medication called corticosteroid
  • By limiting the amount of fluid and salt your child has in their diet
  • With a medication called a diuretic (water pills), which will help reduce the swelling in your child’s body

Corticosteroids and limiting salt and fluids in your child’s diet are more common treatments than water pills. Your child’s nephrologist will tell you if your child needs water pills.

The chart below helps explain some of the different treatments we use for nephrotic syndrome. Not all treatments are listed. We will talk with you if your child needs treatment that isn’t on the chart.

 

The Corticosteroids Did Not Help. What Other Treatments Are There?

Sometimes, the corticosteroids do not help as well as they should or at all. This is true if your child relapses often or has bad side effects from the corticosteroids. If this happens, we will give your child a medication called a cytotoxic agent for 8-12 weeks.

If a cytotoxic agent does not help OR if your child has bad side effects, we will give your child a medication called a calcineurin inhibitor. Your child will take this for about 6 months. If it doesn’t work after 6 months, your child will stop taking it and we will talk with you about other treatment options.

Your child’s nephrologist might do a kidney biopsy before giving your child a calcineurin inhibitor. This is to make sure that your child’s kidneys are healthy enough because the medication can cause interstitial fibrosis (kidney scarring). We will talk with you if we think your child needs a kidney biopsy.