Background Telemedicine has the potential to provide secure and cost-effective healthcare at the touch of a button. Nephrotic syndrome is a chronic childhood illness involving frequent relapses and demands long/complex treatment. Hence, developing a remote means of doctor-patient interface will ensure the provision of quality healthcare to patients. Methods The Utsarjan mobile App framework was built with Flutter that enables cross-platform development (Android, iOS, Windows) with speed, smoothness, and open-source benefits. The frontend uses Dart for user interaction, while the backend employs Node.js, Express, and NGINX for APIs, load balancing and high performance. MongoDB ensures a flexible database, Bcrypt secures passwords, PM2 handles deployment, uptime and logs, while Firebase Cloud Messaging powers free push notifications. Results Utsarjan (means excretion) is a multi-functional smartphone application for giving nephrotic care and real-time assistance to all patients (especially those in rural regions and/or who do not have access to specialists). It helps patients and doctors by ensuring opportune visits, recording each clinical test/parameter and improving medication adherence. It gives a graphical visualization of relapses, medicine dosage as well as different anthropometric parameters (urine protein, BP, height and weight). This is the first nephrotic care App that enables prompt access to doctor's advice. Conclusions Utsarjan is a mobile App to provide kidney care and real-time assistance to children with nephrotic syndrome. It gives a graphical overview of changes in a patient's health over the long course of treatment. This will assist doctors in appropriately modifying the treatment regimen. Consequently, it will (hopefully) lead to the prevention of relapses and/or complications.