Can nephrotic syndrome be clinically cured?

Written by Zhou Qi
Nephrology
Updated on September 09, 2024
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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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Written by Zhou Qi
Nephrology
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Why does nephrotic syndrome cause sleepiness?

Excessive sleepiness is not a common clinical manifestation of nephrotic syndrome; generally, patients with nephrotic syndrome rarely exhibit excessive sleepiness. If a patient does display sleepiness, it is necessary to investigate the causes, such as a reduction in blood volume and decreased blood pressure caused by nephrotic syndrome, leading to insufficient cerebral blood supply. Furthermore, in cases of nephrotic syndrome, the patient’s immune capacity decreases, making them more susceptible to various infections, such as infections of the upper respiratory tract and lungs. When inflamed, patients are also likely to feel excessively sleepy. In some patients, there is a risk of cerebral infarction, which can also cause sleepiness.

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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 Li Liu Sheng
Nephrology
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How to reduce swelling in the feet caused by nephrotic syndrome?

Swelling of the feet is a common phenomenon in nephrotic syndrome. Once swelling occurs, patients feel uncomfortable symptoms and a sensation of heaviness in their feet, so corresponding de-swelling treatment is necessary. How to reduce swelling? Firstly, a low-salt diet is essential to control salt intake, with daily salt consumption around 2 to 3 grams. In addition to this, small doses of diuretics such as hydrochlorothiazide and spironolactone can be used. If the diuretic effect is not satisfactory, other more potent diuretics like furosemide may be added. Of course, the fundamental treatment for foot swelling in nephrotic syndrome involves the use of steroids and immunosuppressants. This treatment works by suppressing the permeability of the glomerular basement membrane and reducing protein leakage, thereby ultimately eliminating the foot swelling.

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Written by Zhang Hui
Nephrology
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How should you eat with nephrotic syndrome?

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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Causes of edema in nephrotic syndrome

Edema is a diagnostic criterion for nephrotic syndrome, as well as a major clinical symptom and characteristic of the syndrome. There are several reasons why patients develop edema. First, a large amount of protein leaks out from the kidneys, causing a decrease in the concentration of plasma albumin and a decrease in the colloid osmotic pressure in the plasma, which makes it easy for water to move from inside the blood vessels to outside, causing edema. Second, patients with nephrotic syndrome have increased vascular permeability, which also makes it easy for water to enter the interstitial tissues. Among patients with nephrotic syndrome, some are prone to acute renal failure, which further decreases the kidney's ability to excrete water, and these factors together lead to the common occurrence of edema in patients.