Q. In nephrotic syndrome, protein leaks from the larger filter of kidney. Is it true?
Hi doctor,
I heard that in nephrotic syndrome the filtering unit of kidney becomes larger and so protein comes in urine. I am a patient of cortisone dependent nephrotic syndrome over 15 years. Doctor says that about 95 percent of children will get cured at the age of 18. I am 17 years old now. When a child grows, does the filtering unit become smaller? And what happens to the remaining 5 percent? I have anemia, but otherwise normal. Only albumin comes in urine. I also heard that kidney biopsy is done for nephrotic syndrome. But no doctor advised me for biopsy. Do I have minimal change disease?
Hi,
Welcome to icliniq.com.
Yes, you have heard the things right. Due to increased pore there is protein in urine. The best treatment remains the Cortisone. In cases where there is no response to Cortisone as evidenced by persistence of albumin in urine, we need to shift those patients on Cyclophosphamide and Azathioprine.
Renal biopsy can be performed but since you are on steroids the reports may be altered. You need to get C3 (complement component 3), C4 (complement component 4), ANA (antinuclear antibody), ANCA (antineutrophil cytoplasmic antibody) and urine protein to creatinine ratio.
Thank you doctor,
What is C3, C4, ANA, ANCA? Is there any problem with creatinine? Only albumin present in urine. Is urine protein to creatinine ratio necessary?
Hi,
Welcome back to icliniq.com.
These tests we perform to rule out any evidence of autoimmune kidney dysfunction, which can cause such issues. Most common reason is idiopathic nephrotic syndrome, but we call idiopathic only when we are sure there are no other causes.
Rise in serum creatinine does not occur in nephrotic syndrome commonly. We need urine protein to creatinine ratio, in order to monitor the albuminuria as a guide to the diagnosis. I would recommend in such case, to get either 24-hour urine protein or protein to creatinine ratio.
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