Dr. Geetha Priyadarsini Kamminana
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My daughter has been taking birth control pills for five months, since she gave birth. About two months ago, she started having some swelling in her feet and legs. She waited to see if it would go away, but it did not. Her doctor did some tests and found protein in the urine, so she sent her to a nephrologist. The nephrologist did more tests and found that she has nephrotic syndrome and is going for a kidney biopsy to see what medicine she should take to reverse the damage. I am convinced that it came from birth control pills, because it says in the side effects fluid retention in legs and feet. Has this caused any permanent damage? Is this reversible? The nephrologist said it could not come from the birth control and I disagree. I told my daughter to stop taking this pill as soon as she found out from her interest that there is protein in the urine. She has been off of it for two weeks now. My mom is a pharmacist and so I know how dangerous medicines can be and both my parents were sensitive to medicines. My daughter has a kidney biopsy scheduled for next week. I would like to get it earlier, but the recommended intervention radiologist cannot do it before then. My question is can she get the biopsy done with a cold that she has right now? Is it dangerous to wait until next week for the biopsy?
Hello,
Welcome to icliniq.com. I understand your concern regarding the relationship between birth control pills and nephrotic syndrome. It is correct that birth control pills are not known to directly cause nephrotic syndrome or protein in urine. Nephrotic syndrome is characterized by the presence of nephrotic range proteinuria (more than 3 g of protein in urine) along with low serum albumin levels and edema. The underlying cause of nephrotic syndrome can be confirmed through a renal biopsy, which helps identify the specific etiology. In addition to renal biopsy, other tests such as serum albumin, serum lipid profile, serologic studies for infection and immune abnormalities, and urine sediment examination are conducted to evaluate and understand the condition.
Renal biopsy may have contraindications in cases of bleeding disorders, hypertension, shrunken kidney, and pyelonephritis. However, if the patient does not have high fever with chills, rigor, or cough, the biopsy can be safely performed. Regarding the use of Heather, a mini pill containing the hormone Norethindrone, it is not associated with nephrotic syndrome to the best of my knowledge. However, it may cause water retention, leading to swelling of the feet and puffiness of the face. Discontinuing the medication is a good decision if it is causing these side effects. Please be assured that nephrotic syndrome is a treatable condition. It is important to confirm the diagnosis, determine the cause and extent of the disease through renal biopsy, and continue the ongoing treatment.
Thank you for your trust in our telemedicine services, and we are here to support you throughout the treatment process.
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Internal Medicine
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