Testing for and diagnosing nephrotic syndrome in children
Nephrotic syndrome explained:
Nephrotic syndrome is a condition which affects the kidneys and the miniscule filtering system within it, called the nephrons. There is damage to these structures as a result of various reasons, and mostly in children the cause remains unknown, also known as idiopathic nephrotic syndrome. As a result of this damage, the kidney starts to filter less of the substances that it usually helps our body get rid of, and it also starts to filter in excess certain substances which are useful to the body. Therefore an affected child usually presents with certain characteristic symptoms, including, swelling of the tissues, especially in the face and abdomen.
Diagnosing the condition:
It is when a child presents with this characteristic symptom of swelling in most areas of the body, that your doctor/pediatrician will suspect nephrotic syndrome. It is very important that the diagnosis is made correctly, because only then can prompt treatment be started in order to effectively manage the condition. Nephrotic syndrome is a condition which can be accurately diagnosed using a few tests, because the condition has some telltale signs which can easily be detected.
The investigations used to diagnose nephrotic syndrome:
The diagnostic tests which are carried out when a doctor suspects nephrotic syndrome in your child include:
- Urine test – to look for the levels of protein in the urine, because nephrotic syndrome results in increased leakage of protein form the kidney and high levels of protein in the urine. The urine is also tested under the microscope in order to look for signs of inflammation of the kidney and kidney damage, which may indicate the type of nephrotic syndrome your child is suffering from.
- Blood test – in order to look for the level of protein in the blood, because the increased leakage of protein in the urine, will result in reduced levels of protein in the blood, which is the reason why the child develops swelling within the body tissues.
- Renal biopsy – Children usually do not require kidney biopsy at the onset. Which is a test where a small sample of kidney tissue is drawn out using a needle, and viewed under a microscope, in order to see the changes which have occurred in the kidney tissue. Some children may require additional immunosuppression if they frequently relapse or are steroid dependent.
Nephrotic syndrome can present in two forms. The first known as Minimal Change Disease is the most common form to affect children, and is a form that doesn’t show a lot of damage or change in the urine test, and even in the biopsy, there will not be any identifiable damage to the filtering system of the kidney. The second form known as Focal Glomerular Sclerosis, is a more aggressive form of the disease, and shows extensive damage in the urine test as well as renal biopsy.
On certain occasions, if your child is very symptomatic, your doctor will begin treatment straight away without waiting for the tests to confirm which form of nephrotic syndrome your child is suffering from. The treatment for nephrotic syndrome is a course of steroids, which are administered daily, till your child becomes symptom free. Once the treatment has commenced if it is minimal change disease, it will respond well to the treatment and immediate signs of improvement can be seen in your child. But if it Focal Glomerular Sclerosis, then it will not respond well to treatment with steroids.