Diagnosis

Tests and procedures used to diagnose nephrotic syndrome include:

  • Urine tests. A urinalysis can reveal abnormalities in your urine, such as large amounts of protein, if you have nephrotic syndrome. You may be asked to collect urine samples over 24 hours for an accurate measure of the protein in your urine.
  • Blood tests. If you have nephrotic syndrome, a blood test may show low levels of the protein albumin (hypoalbuminemia) specifically and often decreased levels of blood protein overall. Loss of albumin is often associated with an increase in blood cholesterol and blood triglycerides. Serum creatinine and blood urea also may be measured to assess your overall kidney function.
  • Removing a sample of kidney tissue for testing. Your doctor may recommend a procedure called a kidney biopsy to remove a small sample of kidney tissue for testing. During a kidney biopsy, a special needle is inserted through your skin and into your kidney. Kidney tissue is collected and sent to a lab for testing.

Treatment

Treatment for nephrotic syndrome involves treating any underlying medical condition that may be causing your nephrotic syndrome. Your doctor may also recommend medications that may help control your signs and symptoms or treat complications of nephrotic syndrome. Medications may include:

  • Blood pressure medications. Drugs called angiotensin-converting enzyme inhibitors reduce blood pressure and also reduce the amount of protein released in urine. Medications in this category include benazepril (Lotensin), captopril (Capoten) and enalapril (Vasotec). Another group of drugs that works in a similar way is called angiotensin II receptor blockers and includes losartan (Cozaar) and valsartan (Diovan).
  • Water pills. Water pills (diuretics) help control swelling by increasing your kidneys' fluid output. Diuretic medications include furosemide (Lasix) and spironolactone (Aldactone).
  • Cholesterol-reducing medications. Medications called statins can help lower cholesterol levels. However, it's currently unclear whether or not cholesterol-lowering medications can specifically improve the outcomes of people with nephrotic syndrome, such as avoiding heart attacks or decreasing the risk of early death. Statins include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).
  • Blood thinners. Medications called anticoagulants help decrease your blood's ability to clot and reduce your risk of developing blood clots. Anticoagulants include heparin or warfarin (Coumadin).
  • Immune system-suppressing medications. Medications to control the immune system, such as corticosteroids, may decrease the inflammation that accompanies certain kidney disorders, such as minimal change disease.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

Changes to your diet may help you cope with nephrotic syndrome. Your doctor may refer you to a dietitian to discuss how what you eat can help you cope with the complications of nephrotic syndrome. A dietitian may recommend that you:

  • Choose lean sources of protein
  • Reduce the amount of fat and cholesterol in your diet to help control your blood cholesterol levels
  • Eat a low-salt diet to help control the swelling (edema) you experience

Preparing for your appointment

If you have signs and symptoms that cause concern, start by seeing your family doctor or a general practitioner. If your doctor suspects you may have a kidney problem, such as nephrotic syndrome, you may be referred to a doctor who specializes in the kidneys (nephrologist).

Here's some information to help you get ready for your appointment and what to expect from your doctor.

What you can do

Before your appointment:

  • Be aware of any pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.
  • Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements that you're taking.
  • Consider taking a family member or friend along, to help you remember all the information provided during the appointment.
  • Write down questions to ask your doctor.

Preparing a list of questions ahead of time can help you make the most of your time with your doctor. For nephrotic syndrome, some basic questions to ask your doctor include:

  • What's the most likely cause of my nephrotic syndrome?
  • What tests do I need?
  • Is this condition likely temporary, or will I always have it?
  • What are my treatment options? And which do you recommend for me?
  • What are the risks and benefits of each treatment?
  • Are there changes I can make to my diet to help me feel better? Could a dietitian help me?
  • I have other health conditions. How can I best manage these conditions together?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there brochures or other printed material that I can take with me? What websites do you recommend?
  • How do I know when I need to plan for a follow-up visit? Are there any symptoms that suggest I should call for advice right away?

In addition to the questions that you prepare ahead of time, don't hesitate to ask other questions that occur to you during your visit.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • When did you first notice your symptoms?
  • Do your symptoms come and go, or do you have them all the time?
  • How severe are your symptoms?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Dec. 18, 2014
References
  1. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Oct. 26, 2014.
  2. Papadakis MA, ed., et al. Current Medical Diagnosis & Treatment 2014. 53rd ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://accessmedicine.mhmedical.com/book.aspx?bookId=330. Accessed Oct. 26, 2014.
  3. Nephrotic syndrome in adults. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/KUDiseases/pubs/nephrotic/index.aspx. Accessed Oct. 25, 2014.
  4. Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed Oct. 25, 2014.
  5. Taal MW, et al, eds. Brenner & Rector's The Kidney. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Oct. 25, 2014.
  6. Kong X, et al. Lipid-lowering agents for nephrotic syndrome (Review). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005425.pub2/abstract. Accessed Oct. 25, 2014.