Nephrotic Syndrome in Adults and Children: Key Differences and Treatment Approaches

Nephrotic Syndrome in Adults and Children: Key Differences and Treatment Approaches

Nephrotic syndrome is a kidney disorder that causes excessive protein loss in urine, leading to swelling, high cholesterol, and an increased risk of infections. While both adults and children can develop nephrotic syndrome, the underlying causes, symptoms, and response to treatment often differ. In this blog, Dr. Avinandan Banerjee, a renowned nephrologist, explains the differences in how nephrotic syndrome affects different age groups and the best treatment options available.

What is Nephrotic Syndrome?

Nephrotic syndrome occurs when the kidney’s filtering units (glomeruli) are damaged, allowing protein (mainly albumin) to leak into the urine. This leads to:
✔ Swelling (edema) in the face, legs, and abdomen
✔ High levels of cholesterol and triglycerides
✔ Increased risk of infections and blood clots
✔ Foamy urine due to excess protein loss

Key Differences Between Adults and Children

Factor

Children

Adults

Most Common Cause

Minimal Change Disease (MCD)

Focal Segmental Glomerulosclerosis (FSGS), Membranous Nephropathy

Symptoms

Facial swelling (especially in the morning), fatigue, foamy urine

Leg and ankle swelling, high blood pressure, proteinuria

Response to Treatment

Often responds well to corticosteroids

May require immunosuppressants and long-term management

Risk of Progression

Lower risk of chronic kidney disease (CKD)

Higher risk of CKD if untreated

Treatment Approaches

1. Corticosteroids

• Children: Minimal Change Disease (MCD) is highly responsive to steroids like Prednisolone.

• Adults: Treatment depends on the underlying cause. Some may need additional immunosuppressive drugs.

2. Medications to Control Symptoms

• Diuretics help reduce swelling by removing excess fluid.

• ACE inhibitors or ARBs lower protein loss in urine and control blood pressure.

• Statins may be needed for high cholesterol levels.

3. Dietary Adjustments

• Low-sodium diet to manage fluid retention.

• Adequate protein intake to compensate for protein loss.

• Avoid processed foods high in cholesterol and fat.

4. Immunosuppressive Therapy

• For steroid-resistant cases, drugs like Cyclophosphamide, Tacrolimus, or Rituximab may be needed.

5. Long-Term Monitoring

• Regular urine and blood tests to track kidney function.

• Blood pressure and cholesterol management to prevent complications.

When to See a Doctor?

If you or your child experiences persistent swelling, foamy urine, or unusual fatigue, consult a nephrologist immediately. Early diagnosis and treatment can prevent complications like kidney failure.

Final Thoughts by Dr. Avinandan Banerjee

"Nephrotic syndrome can be well-managed with early intervention and the right treatment approach. While children often have a better prognosis, adults need more long-term care. Regular follow-ups and lifestyle modifications play a crucial role in preventing kidney damage."

If you or your loved one is experiencing symptoms of nephrotic syndrome, consult Dr. Avinandan Banerjee for expert guidance and personalized treatment.