What is nephrotic syndrome?

Written by Wu Ji
Nephrology
Updated on September 27, 2024
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Nephrotic syndrome is a common manifestation of glomerular disease, caused by a variety of etiologies, with large differences in treatment response and prognosis. The pathological causes of nephrotic syndrome are diverse, with the most common types being minimal change disease, focal segmental glomerulosclerosis, mesangial proliferative nephritis, membranous nephropathy, and membranoproliferative glomerulonephritis. Nephrotic syndrome can be classified into primary and secondary types based on its cause. The diagnosis of primary nephrotic syndrome mainly depends on the exclusion of secondary nephrotic syndrome. Common causes of secondary nephrotic syndrome include diabetic nephropathy, lupus nephritis, renal amyloidosis, drug-induced nephropathy, and renal tumors.

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Can nephrotic syndrome be clinically cured?

Nephrotic syndrome, a disease that clinically cannot be completely cured, is a chronic illness with no concept of cure. However, with appropriate treatment plans, many patients can achieve effective relief. There are two criteria for judging treatment effectiveness: first, the patient's 24-hour urinary protein quantification is controlled below 0.5 grams, and even can be controlled below 0.3 grams. Second, the patient's 24-hour urinary protein quantification is reduced by more than half compared to the baseline value. Both scenarios indicate effective treatment, but achieving a complete cure is difficult.

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Do you take steroids for nephrotic syndrome?

Once nephrotic syndrome is diagnosed, corticosteroid therapy becomes a primary treatment, and the commonly used steroid is prednisone. If there is liver damage or the treatment effect of prednisone is not good, oral prednisolone or intravenous methylprednisolone can be used. Due to its long half-life and severe side effects, dexamethasone is now generally less used. The course of treatment with corticosteroids for nephrotic syndrome is relatively long, needing about one to one and a half years. During this process, the use of steroids has three phases: the initial full-dose phase, during which a relatively large dose of the hormone is used for about two to three months; the second phase is a slow reduction process; the third phase is a low-dose maintenance process. Overall, during the use of steroids, patients must regularly follow up at outpatient clinics, and adjust the steroids according to the doctor's advice. One must not arbitrarily reduce the dose or stop the medication, as this can easily lead to a relapse of nephrotic syndrome.

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Does nephrotic syndrome cause itchy skin?

Nephrotic syndrome generally does not cause itchy skin in patients. In patients with nephrotic syndrome, the glomerular filtration barrier is severely damaged, leading to a significant presence of urinary protein and edema, but itchy skin is a rare clinical symptom. If a patient experiences itchy skin, it is recommended to visit the dermatology department of a standard hospital. As such patients may have a disordered immune system, they are prone to various skin issues, such as allergic dermatitis and eczema, which might cause symptoms of itchy skin. However, these are not directly related to nephrotic syndrome.

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Written by Zhou Qi
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How to maintain health with nephrotic syndrome

Patients with nephrotic syndrome should pay attention to maintenance because nephrotic syndrome is a chronic disease. Even if the condition is well controlled, it can still recur or worsen under certain circumstances. First and foremost, patients should avoid various inflammations, including infections of the upper respiratory tract, enteritis, skin infections, ulcers, etc. Patients should avoid getting cold, avoid contact with people who have colds, and wear masks in crowded places. Avoid eating raw, unhygienic food to prevent diarrhea and enteritis. Patients should also limit their salt intake, and it is recommended that their daily salt intake be controlled between 3 and 6 grams.

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Written by Zhang Hui
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Characteristics of Nephrotic Syndrome

The characteristics of nephrotic syndrome are defined by significant proteinuria, where significant proteinuria refers to urinary protein exceeding 3.5 grams in 24 hours; hypoproteinemia, which refers to blood albumin levels below 30 grams per liter; edema, which may present in facial and lower limbs, and even severe patients may exhibit generalized edema around both lower limbs; and hyperlipidemia, characterized by increased cholesterol and triglycerides in the blood. These patients may exhibit reduced urine output, edema, and noticeably increased foam in the urine.