Patient Education: Nephrotic Syndrome

What is Nephrotic Syndrome?

Nephrotic syndrome is a kidney problem. The kidneys normally clean waste and extra water from the blood. With nephrotic syndrome, the filters in the kidneys (called glomeruli) are damaged. This makes protein leak into the urine instead of staying in the blood.

What Causes It?

Diseases that damage the kidneys, such as diabetes, lupus, or certain infections
Some medicines
Genetic or inherited conditions
Sometimes the cause is not known

Symptoms

Swelling in the legs, ankles, feet, or around the eyes (edema)
Foamy or bubbly urine (caused by protein loss)
Weight gain from fluid buildup
Feeling tired or weak
Loss of appetite

Complications

If nephrotic syndrome is not treated, it can cause:

Blood clots
High cholesterol
Kidney failure
Infections (because the body loses protective proteins)

How to Reduce Complications

Take medicines exactly as ordered by your doctor
Reduce salt in your diet to lower swelling and blood pressure
Weigh yourself daily and report sudden weight gain
Avoid people who are sick to lower infection risk
Get vaccines as recommended (such as flu and pneumonia shots)
Take steps to prevent falls or injury if swelling makes movement harder

Risks

Children and adults of any age can develop nephrotic syndrome
Higher risk if you have diabetes, lupus, or other kidney diseases
Infections can become more serious in people with nephrotic syndrome

Diet

Eat less salt (avoid salty snacks, canned foods, fast food)
Eat more fresh fruits and vegetables
Choose lean protein, but don’t overdo protein (too much can stress the kidneys)
Limit fat and cholesterol to protect your heart
Drink fluids as your doctor advises (sometimes less fluid is needed)

When to Call the Home Health Nurse or Doctor

New or worsening swelling in legs, feet, or face
Sudden weight gain (more than 2–3 pounds in a day)
Foamy urine or decreased urine output
Fever, sore throat, or other signs of infection
Side effects from medicines (such as muscle cramps, cough, or rash)

When to Call 911

Severe trouble breathing or chest pain
Severe headache, vision changes, or confusion
Coughing up or vomiting blood
Passing no urine at all for more than 12 hours
Signs of a blood clot (sudden pain, swelling, or redness in leg; sudden chest pain or shortness of breath)

Key Points

Nephrotic syndrome is a kidney condition where protein leaks into urine.
It can cause swelling, infections, and blood clots.
Following your diet, taking your medicines, and checking weight can help.
Always call for help if you notice serious symptoms.

PATIENT HOMEWORK/ASSESSMENT

True or False – Nephrotic syndrome happens when protein leaks into the urine.
True or False – Nephrotic syndrome means the kidneys are working normally.
True or False – Swelling in the legs and around the eyes is a common symptom.
True or False – Foamy urine can be a sign of protein loss.
True or False – Eating a lot of salt helps reduce swelling.
True or False – High cholesterol can be a complication of nephrotic syndrome.
True or False – Infections are more common because the body loses protective proteins.
True or False – Daily weight checks help track fluid buildup.
True or False – You should stop your medicines if you start feeling better.
True or False – Some causes of nephrotic syndrome include diabetes and lupus.
True or False – Children and adults can both get nephrotic syndrome.
True or False – Eating fatty and fried foods is good for kidney health.
True or False – A healthy diet includes fresh fruits, vegetables, and lean protein.
True or False – Avoiding sick people lowers your risk of infection.
True or False – You should drink large amounts of water no matter what your doctor says.
True or False – Call your nurse or doctor if you gain more than 2–3 pounds in one day.
True or False – Call your doctor if you develop a fever or sore throat.
True or False – Chest pain or trouble breathing should wait until your next appointment.
True or False – Signs of a blood clot, like sudden leg swelling, need emergency care.
True or False – Following medicine and diet plans helps reduce complications.

Individualized Patient-Focused Questions

Symptom Identification: What changes in your body (like swelling or foamy urine) will you watch for that mean your nephrotic syndrome may be getting worse?
Activity Impact/Safety: How does swelling in your feet or legs affect your daily activities, and what safety steps can help you move around safely?
Treatment Adherence: How do you plan to remember to take your medicines each day, even when you feel better?
Preventive Measures: What changes in your diet at home will help reduce swelling and protect your kidneys?
Monitoring: How will you keep track of your daily weight, and when will you call your nurse or doctor about changes?
Infection Risk: What steps can you take at home to lower your chance of infection?
Emergency Awareness: Can you explain when you should call your nurse or doctor versus when you should call 911?
Support Needs: What help do you need from your family or caregivers to manage your nephrotic syndrome safely?

Answer Key: Nephrotic Syndrome True/False

True – Nephrotic syndrome happens when protein leaks into the urine because the kidney filters are damaged.
False – Nephrotic syndrome does not mean the kidneys are normal; it means the kidneys are not working correctly.
True – Swelling in the legs, ankles, feet, or around the eyes is a common symptom of nephrotic syndrome.
True – Foamy or bubbly urine is a sign of protein leaking into the urine.
False – Eating a lot of salt makes swelling worse because salt makes the body hold on to more fluid.
True – High cholesterol can be a complication of nephrotic syndrome because the liver makes more fat in response to protein loss.
True – Infections are more common since important proteins that fight infection are lost in the urine.
True – Daily weight checks help track fluid buildup and show if swelling is getting worse.
False – You should never stop your medicines without talking to your doctor, even if you feel better.
True – Diabetes, lupus, and some infections are known causes of nephrotic syndrome.
True – Both children and adults can develop nephrotic syndrome.
False – Eating fatty and fried foods is harmful; it raises cholesterol and stresses the kidneys and heart.
True – A healthy diet includes fresh fruits, vegetables, lean protein, and low salt to support kidney health.
True – Avoiding people who are sick helps reduce infection risk since nephrotic syndrome makes infections easier to get.
False – You should only drink the amount of fluid your doctor recommends. Drinking too much can worsen swelling and strain your kidneys.
True – A sudden weight gain of 2–3 pounds in one day can mean fluid is building up and should be reported to your nurse or doctor.
True – Fever or sore throat may signal an infection, which is dangerous in nephrotic syndrome, so you must call your doctor.
False – Chest pain or trouble breathing is an emergency and requires calling 911, not waiting for your next appointment.
True – Signs of a blood clot, such as sudden leg pain, swelling, or chest pain, need emergency care.
True – Following your medicine plan and diet helps reduce complications like swelling, infections, and kidney damage.