Nephrotic Syndrome in Children

‘Nephrotic Syndrome’ is a description of symptoms which commonly includes oedema (swelling of the tissues) which can be observed in the face and legs, and proteinuria (protein in the urine). Increased thirst is often reported.

Many aspects of nephrotic syndrome are similar in children and adults, and general information on nephrotic syndrome can be found here (Click here to go to ‘nephrotic syndrome in adults’ section).

However, there are several very important differences between nephrotic syndrome in adults and children, mainly because minimal change nephropathy (Click here for information on this) is by far the commonest cause of nephrotic syndrome, and some other conditions such as amyloid are virtually never seen in children.

Nephrotic syndrome commonly appears in early childhood. Although the appearance of swelling can be alarming, the amount of swelling and proteinuria has no bearing on the outcome and most children grow out of the condition by their early teens with no long-term kidney damage.

Although a kidney biopsy is usually performed in adults with nephrotic syndrome, a biopsy is usually not necessary in children, and is kept in reserve for those who do not respond quickly to steroid (prednsiolone) treatment.

Treatment with steroids (prednisolone) has been shown to alleviate the condition, although relapses can be expected. Because the swelling is salt and water, salty foods should be avoided.

If steroids do not work, or if there are relapses when the steroid dose is reduced, another drug may need to be added. There is a choice of drugs which should be discussed with the specialist. There are drugs with powerful effects on the immune system, such as cyclophosphamide. A less powerful drug that may be useful in some children is called levamisole. The choice of drug is not simple and depends on the balance of risks of benefits in each individual child.

More than 90% of children will reach adulthood with normal renal function. However, a rare condition called congenital nephrotic syndrome which occurs in the first three months of life can lead to renal failure. In this event, early intervention with dialysis and transplantation has been shown to give a favourable outcome.

NKF Controlled Document No. 289, Nephrotic Syndrome in Children, written 25 September 2006. Last reviewed 29 November 2010.

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

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