Nephrotic syndrome

For a lay person:

Nephrotic syndrome is a kidney condition in which the kidneys' filters leak large amounts of protein into the urine. This causes swelling, often first around the eyes and then in the legs and abdomen, and foamy urine. In children it is usually a type that responds well to treatment, while in adults it more often reflects another kidney or general disease.

For a trained medical person:

A clinical syndrome of heavy proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia from glomerular podocyte injury; minimal change disease predominates in children, while membranous nephropathy, FSGS and secondary causes such as diabetes, lupus and amyloidosis are common in adults. Diagnosis is by urine protein quantification, serum albumin and renal function, with renal biopsy in most adults and in atypical childhood cases. Management is corticosteroids for childhood idiopathic disease, cause-specific immunosuppression in adults, plus diuretics, ACE inhibition, statins, and attention to thrombosis and infection risk.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Spleen Qi Deficiency and Damp Accumulation; Spleen and Kidney Yang Deficiency; Yin Deficiency with Damp-Heat. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Nephrotic syndrome needs medical diagnosis and treatment; seek urgent care for fever or abdominal pain (risk of infection), breathlessness, leg pain or swelling on one side, or passing very little urine. Some herbs can harm the kidneys or interact with steroids and immunosuppressants, so do not use them without your kidney specialist's advice, and do not stop prescribed steroids suddenly.