Common Complications of Nephrotic Syndrome and What You Need to Know
Understanding the Major Health Risks Associated with Nephrotic Syndrome
Nephrotic syndrome is a serious kidney disorder characterized by excessive protein loss in the urine, low levels of protein in the blood, swelling (edema), and elevated cholesterol. While managing the primary symptoms is crucial, it's equally important to recognize and address the potential complications that can arise. These secondary conditions not only impact quality of life but may also lead to long-term organ damage if left untreated.
1. Increased Risk of Infections Due to Immune Suppression
One of the most common complications of nephrotic syndrome is a heightened susceptibility to infections. This vulnerability primarily stems from the routine use of corticosteroids and immunosuppressive medications, which are often prescribed to control inflammation and reduce proteinuria. These drugs dampen the body's natural immune response, making patients more prone to bacterial, viral, and fungal infections.
Infections frequently occur in the respiratory tract—such as pneumonia—but can also affect the skin, gastrointestinal system, and mucous membranes. Patients should be vigilant about hygiene, stay up to date on vaccinations (where safe and recommended), and seek prompt medical attention at the first sign of infection.
2. Acute Kidney Injury: A Sudden Decline in Renal Function
Previously referred to as acute renal failure, acute kidney injury (AKI) is another significant complication linked to nephrotic syndrome. It can result from several underlying mechanisms categorized as prerenal, intrinsic renal, or postrenal causes.
Prerenal AKI is the most common type in this context and occurs when there's inadequate blood flow to the kidneys. Conditions such as severe diarrhea, excessive sweating, vomiting, or dehydration can drastically reduce effective blood volume, impairing kidney perfusion. If not corrected quickly, this state can progress to permanent kidney damage. Early detection through monitoring of urine output and serum creatinine levels is essential for timely intervention.
3. Thromboembolic Events: The Hidden Danger of Blood Clots
Patients with membranous nephropathy, a leading cause of nephrotic syndrome in adults, face an increased risk of thrombosis—abnormal blood clot formation. The development of clots is closely tied to the syndrome's hallmark feature: massive proteinuria.
Why Are Clots More Likely?
Loss of anticoagulant proteins in the urine, combined with fluid shifts due to edema, leads to hemoconcentration—a condition where the blood becomes thicker and more viscous. This, along with altered liver synthesis of clotting factors, creates a pro-thrombotic state. Deep vein thrombosis (DVT), pulmonary embolism (PE), and even renal vein thrombosis are known risks.
Clinicians often assess individual risk factors and may recommend prophylactic anticoagulation therapy in high-risk cases, especially when albumin levels drop significantly.
4. Dyslipidemia: Managing Elevated Cholesterol and Triglycerides
Lipid abnormalities are nearly universal in nephrotic syndrome. The liver responds to low blood protein levels by increasing the production of lipoproteins, resulting in elevated cholesterol and triglyceride levels. This condition, known as dyslipidemia, raises the long-term risk of cardiovascular diseases such as atherosclerosis, heart attack, and stroke.
Treatment typically involves lifestyle modifications—including a heart-healthy diet and regular physical activity—and may include statins or other lipid-lowering agents under medical supervision. Controlling proteinuria through appropriate disease management often helps normalize lipid profiles over time.
Proactive Care Improves Outcomes
While nephrotic syndrome presents multiple challenges, early diagnosis and comprehensive care can significantly reduce the impact of its complications. Regular monitoring, patient education, and personalized treatment plans play a vital role in preserving kidney function and overall health. If you or a loved one is living with this condition, work closely with your healthcare team to minimize risks and maintain a better quality of life.