Nephrotic Syndrome is a clinical condition resulting from significant damage to the glomerular filtration barrier, leading to excessive loss of protein in the urine. It is not a single disease but a syndrome that reflects underlying glomerular pathology. Nephrotic syndrome is commonly encountered in nephrology practice across the UAE and affects both adults and children, with important implications for kidney health and overall wellbeing.
The defining features of nephrotic syndrome include heavy proteinuria, low serum albumin levels, generalized edema, and metabolic abnormalities such as hyperlipidemia. Loss of albumin reduces oncotic pressure within blood vessels, causing fluid to leak into surrounding tissues and resulting in swelling of the legs, face, abdomen, and sometimes the lungs. The kidneys’ impaired ability to retain essential proteins also increases susceptibility to infections and blood clot formation.

Nephrotic syndrome may arise from primary glomerular diseases such as minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy, or from secondary causes including diabetes, autoimmune diseases, infections, and certain medications. Identifying the underlying cause is critical, as management and prognosis vary widely.
Patients typically present with progressive swelling, frothy urine, weight gain, fatigue, and reduced exercise tolerance. Blood pressure may be normal or elevated. Laboratory evaluation reveals marked proteinuria, hypoalbuminemia, elevated cholesterol, and varying degrees of kidney dysfunction. In some cases, kidney function remains preserved initially but may decline over time.

Diagnosis involves urine testing to quantify protein loss, blood tests to assess kidney function and metabolic complications, imaging studies, and often kidney biopsy to determine the specific glomerular disease responsible. Early diagnosis allows timely initiation of therapy to prevent irreversible kidney damage.

Management focuses on reducing proteinuria, controlling edema, preventing complications, and treating the underlying cause. Blood pressure control and kidney-protective strategies play a central role. Dietary modification and careful fluid management are essential. In immune-mediated conditions, immunosuppressive therapy may be required. Long-term follow-up is necessary due to the risk of relapse and progression to chronic kidney disease.
The course of nephrotic syndrome varies widely. Some patients achieve complete remission, while others experience recurrent relapses or gradual loss of kidney function. Early nephrology involvement, individualized treatment, and close monitoring significantly improve long-term outcomes and quality of life.