Q.1)
What is nephrotic syndrome?
A.1) Nephrotic Syndrome is a common disease in children involving
Kidneys.
Q.2) How does it occur?
A.2) It occurs due to loss of proteins in the urine in large
quantities which reduces the amount of protein in blood. Normally
as little as 150 mg of protein is excreted in urine by kidneys in
a day whilst in Nephrotic Syndrome 2-20 gm may be lost.
Q.3)
How shall the patient present?
A.3)
Patients present with swelling around eyes in the morning in
the early stage, which subsequently spreads to legs, back, abdomen
and whole body. Child may also pass less urine during this time.
Q.4)
How do you diagnose the condition?
A.4)
Diagnosis of NS is by a simple urine examination. Urine tests are
positive for protein (3+ to 4+).
Q5) What is the treatment?
A.5)
In majority of children the cause of nephrotic syndrome is not known
hence there is no curative treatment. But oral prednisolone treatment
is effective in controlling the protein loss in the urine which
is the main problem in NS.
Q.6)
How do you monitor the patient?
A.6)
Since the total course of prednisolone is for 2-3 months, weekly
examination of urine to detect its effect on protein loss is important.
Once the protein loss is controlled, once every 2-4 weeks the urine
test should be done to diagnose recurrence of the disease or relapse
which is diagnosed by reappearance of 3+ to 4+ proteins in urine.
B.P.record, weight of the child, urine output also should be checked
periodically.
Q.7) What precautions does the patient take?
A.7)
The main precautions to be taken are avoidance of infection because
infections are known to cause relapses and in severe cases death
. Boiling the drinking water, avoiding contact with patients with
infections like chickenpox, jaundice, typhoid etc. and giving vaccinations
against the above mentioned diseases are important steps to prevent
infections in NS. There is increased risk of complications in a
child with NS due to infections which may be mild in healthy children.
Q.8) What are the chances of recurrence?
A.8)
Chances of recurrence or relapse of NS is as high as 50-75% in a
Nephrotic child.
Q.9) What to do in case of a relapse?
A.9)
In case of relapse the first step is contact your doctor to treat
the infection which might be responsible for the relapse.
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updated on 6-11-2000
