Special features for children

In contrast to adults, the nephrotic syndrome occurs in 90% of cases in children not as the cause of another disease, but primarily. This is usually the so-called minimal change glomerulonephritis. It often begins without a known cause in children between the ages of three and six years.

Due to damage to the renal corpuscle, increased (at least 3g/day) proteins are excreted with the urine. This leads to a protein deficiency in the blood, which becomes noticeable in the form of water retention. These occur particularly in front of the ankles, on the shinbone and on the eyelids.

The affected child usually does not feel ill, but it quickly gains weight due to the water retention. Minimal change glomerulonephritis in children can be treated with glucocorticoids, which have an anti-inflammatory effect similar to cortisone. The glucocorticoid prednisone is taken in a dosage of 1mg/kg body weight for up to two months.

In the remaining 10% of cases, nephrotic syndrome occurs in children as a result of another disease. This can be congenital autoimmune diseases such as systemic lupus erythematosus or IgA nephritis. The underlying disease is treated.

Duration/Prediction – Is a nephrotic syndrome curable?

The duration and prognosis of the nephrotic syndrome depends on the existing underlying disease and the time of the first diagnosis of the nephrotic syndrome. In children the most common cause of nephrotic syndrome is minimal change glomerulonephritis. If it is the cause, the prognosis is very good in most cases.

If the children are treated with glucocorticoids, the nephrotic syndrome is curable in 90% of the patients. In adults, the underlying diseases are very different. For example, nephrotic syndrome can occur as a consequence of diabetes that has been badly controlled for a long time.If the damage is detected early, monitoring and adjustment of blood glucose levels must be optimized.

This can result in a good prognosis for the patient. If an autoimmune disease is diagnosed late, the prognosis is worse. The kidney is so severely damaged by the underlying disease that it continues to lose its function without the right therapy. This can lead to kidney failure. These patients must then replace the lost detoxification and excretory functions of the kidney by dialysis or a kidney transplant.