How should you eat with nephrotic syndrome?

Written by Zhang Hui
Nephrology
Updated on September 02, 2024
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Nephrotic syndrome is characterized by urine protein greater than 3.5 grams, serum albumin less than 30, the presence of edema, and hyperlipidemia. Patients matching these criteria can be diagnosed with nephrotic syndrome. From its diagnosis, we can see that such patients have a high amount of urine protein and relatively low blood protein. For these patients, it is necessary to control their protein intake, generally suitable at 0.6-0.8 grams per kilogram of body weight per day. Due to hypoalbuminemia, as the liver synthesizes protein, it also leads to an increase in blood lipids. Therefore, patients with nephrotic syndrome need to follow a low-fat diet to avoid further elevation of blood lipids. Additionally, as patients with nephrotic syndrome generally have edema, it is necessary to restrict sodium intake to prevent sodium and water retention, further aggravating the edema.

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Written by Zhou Qi
Nephrology
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Does nephrotic syndrome easily lead to cerebral infarction?

Nephrotic syndrome is a high-risk factor for cerebral infarction, making patients prone to strokes. This is because patients with nephrotic syndrome excrete large amounts of protein in their urine, which reduces protein concentration in the plasma and disrupts the anticoagulant fibrinolysis system, leading to an increased tendency to form blood clots. These clots are prone to develop in the veins of the lower extremities and the renal veins, and cerebral arteries in the skull are also susceptible to occlusion. Therefore, in such patients, if the plasma albumin level is very low, such as below 20 grams per liter, there is a need for routine use of anticoagulant medications.

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Written by Zhou Qi
Nephrology
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Characteristics of Nephrotic Syndrome

The characteristic feature of nephrotic syndrome is that patients may experience edema, which is related to the nature of this disease. The essence of this disease is due to some reason that damages the glomerular capillary filtration barrier. As a result, when blood passes through the glomeruli, it leaks proteins from the blood. A 24-hour urinary protein quantification will exceed 3.5 grams, which constitutes a large amount of urinary protein. Consequently, a large amount of protein is leaked into the urine, causing the protein concentration in the plasma to decrease. This leads to a reduction in the colloidal osmotic pressure of the plasma, causing fluid to move from inside the blood vessels to outside, thus leading to edema. Therefore, the most significant clinical feature of nephrotic syndrome is the potential to cause edema, and severe cases of edema may elevate blood pressure, lead to pulmonary edema, manifesting as difficulty breathing, chest tightness, and shortness of breath.

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Written by Zhou Qi
Nephrology
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How to treat anemia in nephrotic syndrome?

Patients with nephrotic syndrome often do not suffer from anemia. However, if a patient has severe chronic renal failure, renal anemia may occur. Generally, renal anemia occurs when the patient's blood creatinine level exceeds 256 micromoles/liter. Treatment mainly involves the use of erythropoiesis-stimulating agents and iron supplements. If the patient does not have obvious renal failure but exhibits anemia, it is important to investigate the cause. This could include gastrointestinal bleeding, the presence of systemic diseases, or even hematological disorders. For example, lupus nephritis can cause both nephrotic syndrome and anemia. In such cases, high-dose steroids and immunosuppressants may be required as a treatment to fundamentally address the issue.

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Written by Zhou Qi
Nephrology
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Precursors of relapse of nephrotic syndrome

Nephrotic syndrome is characterized by patients having 24-hour urinary protein quantification exceeding 3.5g and blood plasma albumin levels lower than 30g/L. This condition can be long-lasting. Some patients, after treatment, can have their condition effectively controlled, but there is still a possibility of relapse. Such relapses often occur after the patient has been overworked or has caught a cold, but there are also some patients who do not have such triggers. When the condition relapses, the urinary protein level increases again, which might lead to an increase in urine foam. Patients might experience significant swelling in the lower limbs and face among other areas, suggesting a relapse of nephrotic syndrome, and it is important to go to the hospital for relevant tests promptly.

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Is nephrotic syndrome contagious?

So, nephrotic syndrome is a general term for a group of clinical symptoms, a state of disease, and is not essentially an independent disease. Thus, this problem is not infectious. This disease describes the damage to the kidneys due to some reason, leading to the disruption of the integrity of the glomerular filtration barrier, resulting in the patient developing a significant amount of urinary protein. The disease itself is not contagious. However, there are very few cases of nephrotic syndrome that might be caused by hepatitis B virus infecting the kidneys. In such cases, the hepatitis B virus may have a certain level of contagiousness, but even so, it does not imply that nephrotic syndrome itself is contagious. In other words, even if such patients transmit hepatitis B to others, it does not necessarily mean those others will exhibit kidney damage.