What Happens If Nephrotic Syndrome Is Left Untreated?

Nephrotic syndrome is a serious kidney disorder characterized by excessive protein loss in the urine, low levels of protein in the blood, swelling (especially in the legs and around the eyes), and elevated cholesterol. While certain forms may appear mild or temporary, failing to address this condition can lead to life-threatening complications over time.

Types of Nephrotic Syndrome and Their Natural Progression

There are two main categories: primary and secondary nephrotic syndrome. Primary nephrotic syndrome originates directly from kidney disease, with minimal change disease being one of the most common subtypes—particularly in children. In some cases, especially among pediatric patients, minimal change disease may resolve spontaneously within a few months without medical intervention. However, this does not mean that all forms of nephrotic syndrome can be safely ignored.

The Risks of Avoiding Treatment

For many other types—including focal segmental glomerulosclerosis (FSGS) and membranous nephropathy—untreated proteinuria leads to progressive damage in the glomeruli, the filtering units of the kidneys. Over time, this persistent protein leakage causes scarring, also known as glomerulosclerosis, which diminishes kidney function and may eventually result in end-stage renal disease (ESRD), commonly referred to as uremia.

Moreover, chronic hypoalbuminemia—a hallmark of untreated nephrotic syndrome—weakens the immune system, increasing susceptibility to opportunistic infections such as pneumonia and peritonitis. Patients are also at a significantly higher risk of developing venous thromboembolism due to urinary loss of anticoagulant proteins, making blood clots a potentially fatal complication.

Secondary Nephrotic Syndrome: Addressing the Root Cause

Secondary forms arise due to underlying systemic conditions like diabetes mellitus, lupus erythematosus, amyloidosis, or certain infections such as hepatitis B or HIV. If the primary disease is left unmanaged, kidney damage will continue to progress, accelerating the decline in renal function. Without proper treatment targeting both the root cause and kidney-specific symptoms, patients face an increased likelihood of requiring dialysis or kidney transplantation earlier in life.

Long-Term Outlook Without Medical Care

Leaving any form of nephrotic syndrome untreated jeopardizes overall health and longevity. Even when symptoms seem mild initially, ongoing kidney injury often goes unnoticed until irreversible damage has occurred. Early diagnosis and tailored therapy—not only to reduce proteinuria but also to control blood pressure, manage lipid levels, and prevent clotting—are essential for preserving kidney function and improving quality of life.

In summary, while rare cases may show temporary remission without treatment, the vast majority of individuals with nephrotic syndrome require prompt and sustained medical care. Delaying intervention increases the risk of severe complications, including kidney failure, infections, and cardiovascular events. Seeking professional evaluation and adhering to a comprehensive treatment plan offers the best chance for long-term wellness.