Kidney damage in kids: Top pediatrician discusses nephrotic syndrome in children (early signs, risk factors, and treatment)

Kidneys don’t get much attention, but they’re the superheroes of our body. Day in and day out, they filter your blood, get rid of waste, balance fluids, keep your blood pressure steady, and even help your bones and blood stay healthy.

They just keep going, quietly doing their job, until something throws them off balance. When things like poor diet, not drinking enough water, high blood pressure, or diabetes put stress on the kidneys, they start to struggle. Suddenly, toxins and waste begin to build up, and serious problems — like kidney disease or kidney stones — can sneak up.For kids, one trouble spot is nephrotic syndrome. It’s a big deal, especially in younger children — think preschoolers and early elementary school age.

Nephrotic syndrome happens when the tiny filters inside the kidneys get damaged and start letting too much protein leak into the urine. That sets off a whole chain of problems: fluid builds up in the body, swelling appears, and blood chemistry gets thrown out of whack.

If you catch it early and get treatment, you can help your child avoid a lot of trouble down the line.

Nephrotic syndrome: What is it?

So, what exactly is nephrotic syndrome in kids? It’s a disorder where those little filtering units, called glomeruli, stop working the way they should.

Instead of holding on to important proteins like albumin, they let them slip into the urine. When that happens, the body can’t keep fluid balanced, and things go sideways fast. Healthy kidneys act like sieves, letting waste and water pass but keeping the good stuff in.

Damaged filters? That’s when you see protein in the urine (doctors call this proteinuria), low levels of protein in the blood (hypoalbuminemia), and swelling (edema).

Most kids who get nephrotic syndrome are between 2 and 7 years old, and it tends to show up more often in boys.D. Imran S Patel, a well-known pediatricianknown who goes by “drimranpatelofficial” on Instagram, recently shared a video on the social media platform, exhibiting an example of nephrotic syndrome in a 6-year-old kid in his clinic. He also pointed out how the swelling in his eyes appeared more intense in the morning, and then it would go on to become somewhat normal by evening.

So, how to spot the signs that’ll tell you that your child might be suffering from this particular kidney disorder?

Early signs: The red flags

What should parents look out for? The earliest and most obvious sign is swelling. You’ll usually see it around the eyes first, especially in the morning, but it can show up in the ankles, feet, belly, or face, too. Swelling happens because low blood protein lets fluid leak into body tissues. Another big clue is urine that looks unusually foamy or bubbly — too much protein in the urine does that.

If your child suddenly gains weight, especially along with swelling, it’s probably fluid buildup.

Kids might also seem extra tired or less interested in eating. Sometimes, though less often, they’ll complain of belly pain, feel nauseous, or you might see blood in their urine.

Causes and risk factors

Why does this happen?In most cases, doctors can’t find a clear reason — this is called idiopathic nephrotic syndrome. It just shows up out of the blue. But there are known causes, too.

The most common in young kids is Minimal Change Disease (MCD). Under the microscope, the kidney looks almost normal, but it doesn’t work right. Older kids sometimes get something called Focal Segmental Glomerulosclerosis (FSGS), where parts of the filters are scarred.

There’s also membranous nephropathy, which is immune-related and much less common in children. Other times, a bigger health problem is to blame — things like lupus, infections (hepatitis, HIV), blood disorders, or certain meds.

Some babies are even born with genetic issues that cause nephrotic syndrome — that’s called congenital nephrotic syndrome.Now, who’s most at risk?Most cases show up in kids between 2 and 7, and boys get it a bit more often than girls. A lot of the time, there’s no clear cause — it’s just idiopathic. But sometimes another disease, an infection, or a reaction to medication is behind it. And in rare cases, babies are born with forms of nephrotic syndrome linked to genetics or infections they had before birth.

Prevention and management

Nephrotic syndrome can be tough for kids, but it’s something you can manage. Kids dealing with this are more likely to get infections or blood clots, so it’s important to stay on top of vaccines and check in with the doctor regularly. The good news? Most kids, especially those with minimal change disease, get better as they grow. By the time they hit their teen years, a lot of them stop having so many relapses.