Nephrotic Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Nephrotic Syndrome?
A nephrologist, a doctor who treats kidney disease, usually treats nephrotic syndrome. Your primary care doctor can start the evaluation. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is nephrotic syndrome?
Nephrotic syndrome is a group of symptoms that show your kidneys are not working properly. It includes protein in the urine, low protein in the blood, and high cholesterol. Swelling, called edema, is the most common symptom.
Each of the kidney's filtering units has a filter called a glomerulus. Nephrotic syndrome usually happens when these filters are inflamed, which lets too much protein leak from the blood into the urine. It can affect children and adults of all ages.
Symptoms
Symptoms can include:
- Puffy eyelids and swelling in the legs, ankles, feet, lower belly, or other parts of the body.
- Foamy urine.
- Weight gain from holding too much fluid.
- Tiredness.
- Loss of appetite.
- Seizures.
The swelling may be most noticeable in your legs after standing and around your eyes in the morning. Nephrotic syndrome can lead to serious complications, such as:
- Blood clots.
- A higher risk of infection.
- High blood pressure.
- Kidney problems, including chronic kidney disease and kidney failure.
Causes and who gets it
Many disorders can cause it, including kidney-only diseases and diseases that affect many parts of the body, such as diabetes and lupus. Kidney diseases that can cause it include:
- Focal segmental glomerulosclerosis (FSGS), which scars some of the kidney's filters.
- Membranous nephropathy, in which protein builds up in the kidney's filters.
- Minimal change disease, which is the main cause in children.
FSGS is the most common cause in Black adults. Membranous nephropathy is the most common cause in white adults. Other causes include:
- Diabetes and lupus.
- Infections, such as HIV/AIDS, hepatitis B, and hepatitis C.
- Some allergic reactions.
- Some medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
- Genetic disorders that affect the kidneys.
Eating habits and diet have not been shown to cause or prevent nephrotic syndrome.
How doctors diagnose it
Urine tests that show if you are losing too much protein can diagnose nephrotic syndrome. A urine dipstick test is a simple test that checks for albumin, a protein, in your urine. To confirm the diagnosis, your doctor may order one of two urine tests. In a 24-hour urine collection, you collect urine over 24 hours. A urine albumin-to-creatinine ratio (UACR) test uses one urine sample to estimate how much albumin you lose in 24 hours. Blood tests can check for low protein in the blood and other problems linked to the syndrome. Tests to find the cause can include blood tests, imaging tests such as a kidney ultrasound, and a kidney biopsy.
Treatment
Treatment depends on the symptoms, the cause, and how much kidney damage there is. Symptoms are most often treated with these medicines:
- ACE inhibitors and ARBs, which can lower blood pressure and help reduce protein loss.
- A diuretic, or water pill, which reduces swelling by helping the kidneys remove fluid from the blood.
In some cases, doctors also prescribe statins, which are medicines that lower cholesterol. Blood thinners may be used, but usually only if you develop a blood clot. People with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to help prevent infections. Other treatment depends on the cause, and some people need medicines that suppress the immune system. Your doctor may suggest limiting salt and fluids to help control swelling. Your doctor may also suggest eating less fat and cholesterol to help control your blood cholesterol. Once the cause has been treated, nephrotic syndrome may go away and kidney function may return to normal. Symptoms may go away for a time and then come back. You may need treatment for life.
When to see a doctor
Contact your doctor if you or your child has symptoms of nephrotic syndrome, such as swelling in the face, belly, arms, or legs, or skin sores. Also contact your doctor if you are being treated but your symptoms do not improve. New symptoms to report include cough, decreased urine output, discomfort when you urinate, fever, or severe headache. Call 911 or go to the emergency room if you have a seizure, trouble breathing, chest pain, fainting, or confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can order and review urine and blood tests, help you track your blood pressure and symptoms, and coordinate follow-up with a kidney specialist.
Common questions
Is nephrotic syndrome the same as kidney disease?
No, nephrotic syndrome is not a specific kidney disease. It can happen with any kidney disease that damages the filters in a way that lets protein leak into the urine.
Can nephrotic syndrome go away?
Yes, once the cause has been treated, it may go away and kidney function may return to normal.
Can nephrotic syndrome lead to kidney failure?
Yes, in some cases nephrotic syndrome may lead to kidney failure.
Should I eat extra protein if I lose protein in my urine?
No, eating a high-protein diet does not help and may make things worse. Ask your doctor what eating plan is right for you.
Can children get nephrotic syndrome?
Yes, it can affect children and adults of all ages.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases - Nephrotic Syndrome in Adults
- MedlinePlus - Nephrotic syndrome
- National Kidney Foundation - Nephrotic syndrome
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
