Diagnosis

DIAGNOSIS

In addition to a complete medical history and physical examination, diagnostic procedures for nephrotic syndrome may include the following :

measurement of blood pressure
measurement of blood cholesterol levels
measurement of protein levels in the urine
measurement of protein levels in the blood

Diagnosing nephrotic syndrome involves a number of tests, including :

Urine tests – excessive protein makes the urine appear frothy and foamy. A dipstick urine test can also detect protein levels (proteinuria). A 24-hour urine collection or a spot urine protein/creatinine ratio may be done if urine protein is found on the dipstick. These tests measure the amount of protein more precisely and identify whether kidney damage is mild, moderate or heavy.

Blood tests – to check the blood protein and creatinine (waste made by muscle activity) levels.

Biopsy – a small sample of kidney tissue is taken and examined in a laboratory.

Further Tests
Sometimes further tests may be required. These may include :

Ultrasound – an examination of the kidneys using sound waves to outline the structure of organs.

Computerised Tomography (CT) Scan or Magnetic Resonance Imaging (MRI) – using radio-frequency wavelengths and a strong magnetic field to provide clear and detailed pictures of internal organs and tissues.

Complications
The most obvious symptom is usually swelling of the ankles and legs. Extra fluid may also accumulate in the abdomen and around the face, especially overnight. In children and young adults the ankles may be less affected and the abdomen and face more affected. Other diseases cause most ankle swelling; nephrotic syndrome is a rare cause of ankle swelling. Urine tests and blood samples are required to prove that nephrotic syndrome is the cause. The protein leak can sometimes make the urine frothy. Some people feel tired.

Complications of nephrotic syndrome can include :

Dehydration – low protein levels reduce blood volume. In severe cases, intravenous fluids may be given to boost the body’s water content.

Blood clots – in the leg veins and occasionally in the kidney veins. Blood clots can also go into the lungs and cause chest pain, breathlessness or coughing up of blood.

Infection – infection and inflammation (peritonitis) of the peritoneal cavity. This is the thin elastic lining that contains the pancreas, stomach, intestines, liver, gallbladder and other organs. A fever may indicate infection.

Kidney failure – without treatment, the kidneys may fail in extreme cases.