If your child has been diagnosed with nephrotic syndrome (a kidney condition), know that while it requires careful management, most children respond well to treatment! Nephrotic syndrome causes protein to leak into urine, leading to swelling (soojan), especially around eyes and legs. With proper medication and diet, about 80-90% of children achieve remission. It often recurs, but can usually be controlled.
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In Simple Terms:
Key Facts:
Primary Causes (Most Common in Children):
| Type | Description | Response to Treatment |
|---|---|---|
| Minimal Change Disease | Most common (75-85%) | Usually responds well |
| Focal Segmental Glomerulosclerosis (FSGS) | Scarring in kidney | Variable response |
| Membranous Nephropathy | Rare in children | Variable response |
Secondary Causes (Less Common):
Often Unknown:
Classic Signs (Soojan/Swelling):
Other Symptoms:
How Parents Usually Notice:
Diet During Active Disease:
| Do | Don't |
|---|---|
| Low salt (namak kam) | No added salt, pickles, papad |
| Normal protein (unless advised otherwise) | Avoid excessive protein |
| Adequate fluids (as advised) | Avoid excessive fluids |
| Fresh fruits and vegetables | Avoid processed foods |
| Home-cooked food | Avoid packaged/junk food |
Low-Salt Indian Food Tips:
Monitoring at Home:
Seek immediate care if:
Schedule appointment if:
Steroid Treatment (Main Treatment):
Typical Treatment Timeline:
| Phase | Duration | What Happens |
|---|---|---|
| Initial treatment | 4-6 weeks | High dose steroids |
| Tapering | Several weeks | Gradually reduce dose |
| Maintenance | Varies | Low dose or stop |
| Relapse | If occurs | Restart treatment |
Other Medications (if needed):
Common Side Effects:
| Side Effect | Management |
|---|---|
| Increased appetite | Monitor diet, avoid excess weight gain |
| Moon face | Temporary, improves after stopping |
| Mood changes | Be patient, inform doctor if severe |
| Sleep problems | Give medication in morning |
| Increased infection risk | Avoid sick contacts, maintain hygiene |
| Growth effects | Usually temporary |
Important:
Trigger Avoidance:
Lifestyle:
Warning Signs of Relapse:
Good News:
What to Expect:
Expert Insight: Dr. Sumitra advises: 'Growth charts are just one tool. Look at the overall trend, not individual measurements.'
A: Morning puffiness around eyes (especially if it reduces during the day) can be an early sign of nephrotic syndrome. However, it can also be due to allergies, crying, or other causes. If you notice: persistent morning puffiness, swelling in feet/legs too, decreased urination, or foamy urine - get a urine test done immediately. A simple urine test can detect protein and help diagnose.
A: During active disease (relapse), follow a low-salt diet to reduce swelling. Protein intake should be normal (not restricted) unless advised otherwise. Avoid: added salt, pickles, papad, packaged foods, and chips. Use fresh home-cooked food with minimal salt. When in remission, diet can be more relaxed but maintaining low salt is still helpful. Consult your nephrologist for specific advice.
A: We understand the concern! Steroids do have side effects, but they are the most effective treatment for nephrotic syndrome. Side effects like increased appetite and moon face are temporary and resolve after stopping. The alternative (untreated nephrotic syndrome) carries more serious risks. Follow your doctor's dosing carefully - never stop suddenly. The benefits far outweigh the risks when used properly.
A: Most children with nephrotic syndrome have an excellent outlook! The most common type (Minimal Change Disease) usually doesn't cause permanent kidney damage. Many children "outgrow" it by teenage years. Even children who have frequent relapses usually maintain normal kidney function. Regular follow-up helps catch and treat any issues early.
A: If you notice signs of relapse (morning puffiness, weight gain, protein in urine test), contact your doctor promptly. Early treatment of relapse usually leads to quick response. Don't panic - relapses are common and expected in nephrotic syndrome. Your doctor will advise on restarting steroids or adjusting treatment. Keep monitoring and following up regularly.
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This article was reviewed by a pediatrician. Last updated: January 2025
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