Nephrotic Syndrome

Nephrotic syndrome is a condition caused by significant damage to the glomeruli, leading to heavy proteinuria (more than 3.5 g/day), low blood albumin, swelling, and high cholesterol. Common causes include minimal change disease, FSGS, membranous nephropathy, and diabetes-related kidney disease.

At The Medical Group of New Jersey, nephrologists perform a comprehensive evaluation to identify the underlying cause and develop a treatment plan that may include immunosuppression, diuretics, and strategies to reduce protein loss.

Symptom Onset & Initial Evaluation

People with nephrotic syndrome often presents with:

• Noticeable swelling in the legs, ankles, eyelids, or abdomen
• Foamy urine
• Weight gain related to fluid retention
• Fatigue or loss of appetite

Your initial evaluation at The Medical Group of New Jersey may include:

• Reviewing symptoms, recent illnesses, and medications
• Checking for signs of fluid overload
• Measuring blood pressure and assessing cardiovascular risks
• Ordering laboratory tests to evaluate kidney function and protein loss

Diagnosis & Etiologic Workup

Accurate diagnosis requires detailed testing, which may include:

• Urine protein quantification
• Serum albumin and lipid panel
• Renal function testing
• Autoimmune and infectious disease screening
• Kidney biopsy to determine the specific glomerular disease

A kidney biopsy is often essential for distinguishing between minimal change disease, Focal Segmental Glomerulosclerosis (FSGS), membranous nephropathy, or other causes.

Treatment & Long-Term Management

Treatment aims to reduce proteinuria, control swelling, and prevent complications. Your treatment plan may include:

Supportive Therapies

• Diuretics to reduce swelling
• Sodium restriction
• ACE inhibitors or ARBs to reduce protein loss
• Statins to manage high cholesterol
• Anticoagulation in select patients at high risk for blood clots

Immunosuppressive Therapy

Based on biopsy results, your nephrologist may prescribe:

• Corticosteroids
• Calcineurin inhibitors (tacrolimus, cyclosporine)
• Rituximab
• Mycophenolate

Monitoring & Follow-Up

Your nephrologist will:

• Monitor kidney function and urine protein frequently
• Adjust medications to improve response and reduce side effects
• Screen for complications such as infections, thrombosis, and metabolic changes
• Track long-term kidney function for signs of progression toward Chronic Kidney Disease

Prognosis & Preventive Care

Many patients respond well to treatment, especially those with minimal change disease. Others may experience relapses or progression to CKD. Long-term monitoring is essential.

Preventive care includes:

• Maintaining sodium restrictions
• Avoiding NSAIDs
• Following infection prevention strategies
• Keeping blood pressure and cholesterol under control