syndrome is not a disease. The term nephrotic syndrome was coined
by Calvin and Goldberg. The syndrome is characterized by heavy proteinuria,
hypoalbuminemia, edema, hypercholesterolemia, and normal renal function.
Nephrotic syndrome is a nonspecific disorder
in which the kidneys are damaged, causing them to leak
large amounts of protein
(proteinuria at least 3.5
grams per day per 1.73m2 body surface area) from the
blood into the urine.
Nephrotic syndrome is a set of
signs or symptoms that may point to kidney problems. The kidneys
are two bean-shaped organs found in the lower back. Each is about
the size of a fist. They clean the blood by filtering out excess
water and salt and waste products from food. Healthy kidneys keep
protein in the blood, which helps the blood soak up water from tissues.
But kidneys with damaged filters may leak protein into the urine.
As a result, not enough protein is left in the blood to soak up
the water. The water then moves from the blood into body tissues
and causes swelling.
Kidneys affected by nephrotic syndrome have small
pores in the podocytes, large enough to
(and subsequently hypoalbuminemia,
because some of the protein albumin
has gone from the blood to the urine) but not large enough to allow
cells through (hence no hematuria).
By contrast, in nephritic
pass through the pores, causing hematuria.
Childhood nephrotic syndrome can occur at any
age but is most common between the ages of 1Ĺ and 5 years. It seems
to affect boys more often than girls.
Cause of Nephrotic
1. Minimal glomerulonephritis (common in children).
2. Membranous glomerulonephritis (common in adults).
1. Bee sting.
2. Serum sickness.
2. Sub-acute bacterial endocarditis.
1. Diabetes mellitus.
3. Multiple myeloma.
SYMPTOMS of Nephrotic
- Onset: insidious.
- Swelling of face, spreading to whole body.
- Nausea, vomiting.
- Lethargy, tiredness.
- Susceptibility to infections.
- Nephritic facies
- Puffy face.
- Baggy eyelids.
- Waxy pallor.
- Anaemia: mild to moderate.
- Oedema: pitting.
- Pulse: fast.
- Blood pressure: normal or low.
- Flanks full.
- Skin shiny.
- Fluid thrill / shifting dullness present.
- Signs of bilateral hydrothorax may be present.
Venous thrombosis: due to
leak of anti-thrombin 3, which helps prevent thrombosis. This often
occurs in the renal veins. Treatment is with oral anticoagulants
(not heparin as heparin acts via anti-thrombin 3 which is lost in
the proteinuria so it will be ineffective.)
due to leakage of immunoglobulins, encapsulated bacteria such as
Haemophilus influenzae and Streptococcus pneumonia can cause infection.
renal failure is due to hypovolemia. Despite the
excess of fluid in the tissues, there is less fluid in the vasculature.
Decreased blood flow to the kidneys causes them to shutdown. Thus
it is a tricky task to get rid of excess fluid in the body while
maintaining circulatory euvolemia.
Pulmonary edema: again due
to fluid leak, sometimes it leaks into lungs causing hypoxia and dyspnoea.
retardation: does not occur in MCNS.It occurs in cases of
relapses or resistance to therapy. Causes of growth retardation
are protein deficiency from the loss of protein in urine, anorexia (reduced protein
intake), and steroid therapy (catabolism).
Vitamin D deficiency can occur. Thyroxine is reduced due to decreased
thyroid binding globulin.
Microcytic hypochromic anaemia is typical.
It is iron-therapy resistant.
- Bed rest, if severe oedema or infection is present.
- High protien diet: 1.5-3 g / kg.body weight (if
blood urea is normal).
- Salt restriction.
- Fluid restriction according to urinary output
Homeopathy Treatment & Homeopathic Remedies for Nephrotic Syndrome
Homeopathy treats the person as a whole. It means that homeopathic
treatment focuses on the patient as a person, as well as his pathological
condition. The homeopathic medicines are selected after a full individualizing
examination and case-analysis, which includes the medical history
of the patient, physical and mental constitution etc. A miasmatic
tendency (predisposition/susceptibility) is also often taken into
account for the treatment of chronic conditions. The medicines given
below indicate the therapeutic affinity but this is not a complete
and definite guide to the treatment of this condition. The symptoms
listed against each medicine may not be directly related to this
disease because in homeopathy general symptoms and constitutional
indications are also taken into account for selecting a remedy.
To study any of the following remedies in more detail, please visit
our Materia Medica
section. None of these medicines should be taken without professional
†Incipient stage of post scarlatinal nephritis, pain
in loins, scanty urine without blood.
Apis is not so much a remedy for chronic Bright's
disease as for the acuter forms. There are oedematous swellings
of the face and extremities, paleness, ascites, oedema pulmonum,
pains in the head, back and limbs. Albuminuria following scarlatina.
It may be of use in any form of Bright's disease when there are
dull pains in the kidneys, scanty urine and frequent Micturition.
The urine is heavily charged with albumen and contains blood corpuscles.
The oedema appears quickly, there is general dropsy and suppression
of urine and perhaps an eruption of the skin like a nettle rash.
The patient† is drowsy, apathetic and has a bruised feeling all
over. Apis in such cases acts best in trituration; do not depend
on the tincture or dilutions. Hepar is recommended by Kafka in Bright's
disease following scarlatina. A valuable symptom for Apis is the
feeling of suffocation. He does not see how he is get another breath.†
Palliative in dropsical conditions where the urine
is scanty. Also useful for coma & convulsions in the nephritis
This remedy corresponds to all stages of Bright's
disease, bearing a closer resemblance than any other remedy. It
comes in later in the disease where there is dropsy, pale skin,
waxen appearance, watery diarrhea and great thirst. The urine is
dark, casts are abundant, and it contains much albumen. There are
attacks of dyspnoea when lying down in the evening and after midnight,
relieved by an expectoration of
mucus. It may come in immediately after Aconite in
many cases. "Blood boils" make a special indication for
this remedy. Baehr, Millard and Hale question the usefulness of
Arsenicum in kidney affections. However, it seems a simile to the
large white kidney; in fact, one could hardly wish for a closer
correspondence. Hughes considers it a favorite with anxiety and
sinking of vital forces will call for Arsenicum. Calcarea arsenica
has been used in the anaemia, progressive emaciation and debility
of this disease with success.†
Morbus Brightii from gout, suppurations or syphilis.
Interstitial nephritis in its incipiency with digestive and nervous
phenomena, hypochondriasis, irritability and vertigo.†
Simple albuminuria, here it seems to occupy a place
midway between Aconite and Arsenicum. Belladonna is of the greatest
service in inflammation of the kidneys with piercing† burning pains
in the lumbar region, returning periodically with increased severity.
This remedy pictures nephritis with cutting pains
in the lumbar region; the urine is passed in drops and is mixed
with blood, with much urging. Post scarlatinal and post diphtheric
kidney diseases with dropsy may indicate Cantharis.
Nephritis from heart disorders. It affords relief
when there is extreme rapid & irregular action of the heart,
and in general anasarca & ascites from mitral insufficiency.
Cuprum arsenicum is also useful in uraemic conditions
and is praised highly by Goodno. Cuprum is a valuable remedy for
†This remedy has an irritant action on the kidneys.
It is homoeopathic to granular degeneration. Heart symptoms, feeble
pulse, scanty, dark, turbid urine, faintness at the stomach, rheumatic
pains will indicate it. It is especially useful when the circulation
is weak. Rheumatic pains, pulmonary catarrh with profuse expectoration
are marked symptoms.
Glonoine has albuminous urine and will sometimes
be found useful in acute and haemorrhagic nephritis.†
This remedy is said to be the most homoeopathic of
all remedies in Bright's disease. It has scanty, dark, albuminous
urine containing casts. It excites a violent nephritis.†
This remedy corresponds to the large white kidney.
There is an albuminous, scanty and red urine; pale waxen color of
the body; there are lumbar pains, great dyspnoea and excessive strangury.
It takes the first rank among all the mercurials for nephritis,
and it comes in the later stages. Syphilitic complication further
indicate it. There is an expression of uneasiness on the face. Dr.
Ludlam considers it our best remedy for the albuminous nephritis
of pregnancy and Baehr lauds it in suppurative nephritis.
Granular degenerations of the kidneys, with tendency
to uraemic convulsion. Dropsy, sallow face, emaciation, oedema about
the ankles. It seems to corresponds to the contracted or cirrhotic
form of nephritis, holding the same relation here that Arsenic and
Mercury do in chronic nephritis. Royal emphasizes this remedy saying
that it arrested the progress in many cases and permanently cured
not few for him.
Phosphorus produces as marked a nephritis as any
drug. It is one of the most important remedies in Bright's disease;
the characteristic symptoms are: lassitude of† the whole body, hands
and feet icy cold, sleepiness. The fatigue is greatest in the morning,
and there is heat in the body without thirst, especially in the
evening. The patient is indisposed to work, is giddy, forgetful
and has a heavy headache, particularly in the forehead; there is
oedema of the upper eyelids, a mist before the eye, a yellowish
fray complexion, a sickly oedema of the face, want of appetite,
pressure and burning in the stomach, and a light colored painless
diarrhea which is very weakening. It suits well fatty or waxy casts,
is dark brown, scanty and albuminous, or covered with an iridescent
film. Pulmonary complications will call for Phosphorus; and inability
to lie on the left side is a prominent symptom in these cases. Vomiting
and gastric symptoms are usually present. A small dose of Phosphorus
will act much safer and better in eclampsia than a large dose of
One of our reliable and most frequently indicated
remedies in the early stages of renal diseases when congestion is
prominent, when there is much pain in the back of a† dull character
extending along the ureters. The great characteristic of dark smoky
urine will be present. There is anasarca, and of course, the urine
is bloody and albuminous. It is recommended in post scarlatinal
renal affections. The prostration is† not accompanied by the restlessness