Coping Strategies for Nephrotic Syndrome in Pediatric Patients

In the realm of childhood health, nephrotic syndrome is a condition that warrants attention. This ailment affects the kidneys' ability to preserve proteins, leading to their excretion in urine.

Nephrotic syndrome can be primary, secondary, or congenital. Primary, or idiopathic, nephrotic syndrome has no clear-cut cause and can be associated with Minimal Change Disease, focal segmental glomerulosis, and membranoproliferative glomerulonephritis (MPGN). Secondary nephrotic syndrome, on the other hand, is caused by systemic diseases, infections, or overuse of certain medications. Congenital nephrotic syndrome, the hereditary form of the disease, is often linked to genetic variations in the genes NPHS1, NPHS2-Pododsin, and WT1-Wilms tumour suppressor gene.

Children with nephrotic syndrome may experience a range of symptoms. These include oedema (swelling due to fluid retention), albuminuria (protein in the urine), hypoalbuminemia (low levels of proteins in the blood), infections, dyslipidemia (increased cholesterol), and clotting issues. Other potential complications include growth issues, heart disease, blood pressure problems, kidney failure, and various infections.

Diagnosis of childhood nephrotic syndrome involves a series of tests, including urine dipstick test, urine test, blood test, physical exam, family history, ultrasound of the kidney, and in some cases, biopsy.

Once diagnosed, treatment options vary depending on the type of nephrotic syndrome. For primary nephrotic syndrome, treatment may include steroids (like prednisone), medications to lower blood pressure, diuretics, albumin infusion, and kidney transplant in severe cases. For secondary nephrotic syndrome, treatment focuses on addressing the underlying cause, often involving antibiotics to treat infections and medications to treat underlying systemic diseases. Treatment for congenital nephrotic syndrome includes medications to reduce symptoms of nephritis and kidney transplantation as the only available cure.

A restricted diet can help reduce stress on the kidneys for children with nephrotic syndrome. This diet focuses on low-salt foods, low cholesterol, limited fluid intake, low saturated fat, a diet rich in proteins during recovery, and a diet rich in calcium and multivitamins.

It's important to note that nephrotic syndrome can relapse in some children, often triggered by common infections. Prompt medical attention is crucial for managing the relapse. Children who have a known history of the nephrotic disease are at a greater risk of the disease compared to other kids, and boys have a higher chance of developing nephrotic syndrome than girls.

Despite these challenges, the prognosis for childhood nephrotic syndrome is generally good, with many children recovering without any damage to the kidneys after an episode of medications. In the case of congenital nephrotic syndrome, a transplant may be necessary for complete relief from the disease.

In conclusion, understanding nephrotic syndrome in children is essential for early detection and effective treatment. With proper care and management, many children can lead healthy, active lives despite this condition.