Before entering the core of the topic, let’s do a quick recap of what we learnt in school about the structure of our kidneys. Well, to being with, it is a known fact that we all have two kidneys, both looking like two giant beans. The left kidney is slightly higher than your right kidney due to the position of your liver on top of the right kidney. Now let’s look INTO the kidney. Every kidney has approximately 1.2 million number of nephrons. Wait, what is a nephron? Check out the picture below.
The structure above is called a nephron. So, we have 1.2 million of these inside ONE kidney. But we are going to look at only one such nephron when we are talking about kidney disease. The glomerulus (red color) actually consists of a network of capillaries which enters the capsule and exits. The outer layer of glomerulus which is in contact with the capsule is porous, which means it contains tiny little pores to allow molecules of appropriate size to pass through. So, whatever that causes injury to the glomerulus will produce nephrotic syndrome.
Usually, not a lot of molecules get to pass through the glomerular layer, especially the proteins. When there is an injury to the glomerulus, proteins are allowed to pass through the layer to be filtered out into the urine. When proteins are found in the urine (not seen under our naked eyes of course!), it is termed as Proteinuria. Usually, when the urine consists of proteins, bubbles will appear on the surface. If we continuously lose proteins through the urine, our body will be deficient in proteins, which is termed as hypoproteinemia.
Next, lack of protein in the blood will eventually cause the retention of extra fluid outside the vessels, which is termed as edema (swelling). Edema caused by kidney problems usually involves the entire body.
*Trivia: this edema is typically visible first around the eyes instead of other parts of the body. Why? This is because the skin around the eye area is loosely attached to the tissue beneath, so little increase in fluid will swell up the area, without building much pressure in the tissue, which then allows more and more fluid to accumulate. Don’t quite understand? Try pinching your eyelid and then your palm. Which is easier to be pulled out?
Another important thing for people with nephrotic syndrome to worry about is their cholesterol level. Yes, it sounds rather illogical to relate cholesterol, proteins and kidney disease together, but truth is, loss of proteins in our body will stimulate our liver to produce more proteins to compensate. Some of the proteins consist of lipids too, which ultimately raise the level of cholesterol. Well, beware of your cholesterol level if you have these symptoms.
The other symptoms are:
Puffiness around the eyes especially in the morning
Edema over the legs
Fluid in your abdomen which makes it looks very bloated
Loss of appetite
Shortness of breath (fluid may go to the lung)
Nephrotic syndrome is surely not a diagnosis. It is simply a group of symptoms involving the defect of nephrons. In order to get the diagnosis right, the actual cause has to be found. Below are some examples of causes of nephrotic syndrome:
- Diabetes (complication)
- Autoimmune diseases (antibodies attacking your own system)
- Hepatitis B
- Certain drugs
Unfortunately, this disease may become advance and progress to a more severe condition named nephritic syndrome. NEPHRITIC Syndrome is only one alphabet difference with NEPHROTIC Syndrome but they are not entirely alike.
What is Nephritic Syndrome?
In nephritic syndrome, the person can have loss of proteins and edema as well, but also, the person’s urine will look like tea color (picture below) due to the mixing of blood in the urine.
Also, because there is inflammation and swelling of the glomerulus in nephritic syndrome, the person might have fever and decrease in urine formation (oliguria). And due to metabolic changes in nephritic syndrome, the person will develop hypertension. Blood pressure should be monitored frequently in this case.
You can also look out for symptoms such as blurred vision, headache, decreased in urine output or no production at all, edema, fever, cough with mucus, (mucus sometimes contains bubbles)
Nephritic Syndrome is not necessarily caused by nephrotic syndrome, it can be caused by other infections as well.
Not to make these two conditions sound very serious, but if you do have the above symptoms, please consider doing a full body check-up and a blood test to confirm the diagnosis and treat early. Never underestimate the power of early treatment as it can save you a lot of pain in the future! To treat the above conditions, as it has been mentioned, the original cause has to be uncovered and targeted. At the same time, controlling your diet and monitor your blood pressure are equally vital to improve the condition.
Take care of your kidneys, love them like your babies, and we promise they will behave.
by Angie Loh
A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.