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Does protein leak from the larger filter of the kidney?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I heard that in nephrotic syndrome the filtering unit of kidney becomes larger and so protein comes in urine. I am a patient of cortisone dependent nephrotic syndrome over 15 years. Doctor says that about 95 percent of children will get cured at the age of 18.

  1. I am 17 years old now. When a child grows, does the filtering unit become smaller?
  2. And what happens to the remaining 5 percent?

I have anemia, but otherwise normal. Only albumin comes in urine. I also heard that kidney biopsy is done for nephrotic syndrome. But no doctor advised me for biopsy. Do I have minimal change disease?

Please help.

Thank you.
Answered by Dr. Anshul Varshney

Education:

MBBS

Professional Bio:

Dr. Anshul Varshney is a highly skilled Critical Care Physician specializing in nephrology, pulmonology, and rheumatology. He is committed to providing advanced, life-saving care to critically ill patients while addressing complex medical conditions affecting the kidneys, lungs, and immune system. His holistic and multidisciplinary approach ensures comprehensive treatment tailored to individual patient needs.

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Hi,

Welcome to icliniq.com.

Yes, you have heard the things right. Due to increased pore size, protein is present in the urine. The best treatment remains the Cortisone. In cases where there is no response to Cortisone as evidenced by the persistence of albumin in urine, we need to shift those patients on Cyclophosphamide and Azathioprine.

Renal biopsy can be performed, but since you are on steroids, the reports may be altered. You need to obtain C3 (complement component 3), C4 (complement component 4), ANA (antinuclear antibody), ANCA (antineutrophil cytoplasmic antibody), and the urine protein-to-creatinine ratio.

I hope this addresses your concerns.

Please feel free to follow up if you need any additional clarification.

Thank you.

Patient's Query

Hi doctor,

Thank you for the excellent and detailed response.

What is C3, C4, ANA, ANCA? Is there any problem with creatinine? Only albumin present in urine. Is urine protein to creatinine ratio necessary?

Please help.

Thank you.

Answered by Dr. Anshul Varshney

Education:

MBBS

Professional Bio:

Dr. Anshul Varshney is a highly skilled Critical Care Physician specializing in nephrology, pulmonology, and rheumatology. He is committed to providing advanced, life-saving care to critically ill patients while addressing complex medical conditions affecting the kidneys, lungs, and immune system. His holistic and multidisciplinary approach ensures comprehensive treatment tailored to individual patient needs.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Hi,

Welcome back to icliniq.com.

These tests are performed to rule out any evidence of autoimmune kidney dysfunction, which can cause such issues. The most common reason is idiopathic nephrotic syndrome, but we call it idiopathic only when we are sure there are no other causes.

A rise in serum creatinine does not commonly occur in nephrotic syndrome. We need the urine protein-to-creatinine ratio to monitor albuminuria as a guide to diagnosis. I would recommend, in such a case, obtaining either a 24-hour urine protein test or a protein-to-creatinine ratio.

I hope this addresses your concerns.

Please feel free to follow up if you need any additional clarification.

Thank you.

Medically reviewed by Dr. Sneha Kannan
Published At February 1, 2016
Reviewed At June 19, 2026

Education:

MBBS

Professional Bio:

Dr. Anshul Varshney is a highly skilled Critical Care Physician specializing in nephrology, pulmonology, and rheumatology. He is committed to providing advanced, life-saving care to critically ill patients while addressing complex medical conditions affecting the kidneys, lungs, and immune system. His holistic and multidisciplinary approach ensures comprehensive treatment tailored to individual patient needs.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Education:

BDS

Professional Bio:

Dr. Sneha Kannan is a skilled Dental Surgeon with expertise in providing general dental care, including scaling, fillings, and preventive treatments. She does oral surgery procedures such as extractions and minor surgical interventions. She does procedures in restorative dentistry, including crowns, bridges, and dentures. She is an expert in doing endodontic treatments such as root canal therapy. She is well-versed in doing procedures in cosmetic dentistry, including teeth whitening and smile correction. She can provide pediatric dental care for children’s oral health and preventive treatments. She promotes oral hygiene awareness and preventive dental practices.  

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Companion

Nephrotic Syndrome Management and Prognosis Companion

How it works

Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine. Here's what you need to know.

1

Nephrotic
Syndrome

2

Role
Cortisone

3

Alternative
Medications

4

Renal
Biopsy

5

Autoimmune
Tests

6

Monitoring
Albuminuria

This information is based on general medical guidance. It is not a substitute for professional medical advice; consult a qualified clinician.

Always consult a doctor before taking medication; self-medication carries serious health risks. Take exact prescribed doses, and never start, change, or stop treatment without medical supervision.
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Dr. Anshul Varshney

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Education:

MBBS

Professional Bio:

Dr. Anshul Varshney is a highly skilled Critical Care Physician specializing in nephrology, pulmonology, and rheumatology. He is committed to providing advanced, life-saving care to critically ill patients while addressing complex medical conditions affecting the kidneys, lungs, and immune system. His holistic and multidisciplinary approach ensures comprehensive treatment tailored to individual patient needs.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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