What to do if nephrotic syndrome causes leg pain?

Written by Zhou Qi
Nephrology
Updated on September 26, 2024
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Patients with nephrotic syndrome who experience leg pain mostly have conditions unrelated to nephrotic syndrome itself. It could be due to diseases of the skeletal or muscular system. However, some patients might experience leg pain due to thrombosis caused by nephrotic syndrome, leading to ischemia in the limbs. Also, long-term use of corticosteroids can lead to necrosis of the femoral head, osteoporosis, and pain. Therefore, treatment should be targeted based on the cause, such as using drugs to dissolve clots or interventional surgery for those with thrombosis. In severe cases of femoral head necrosis, a femoral head replacement surgery might be necessary, and it is important to supplement with calcium regularly.

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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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Written by Zhou Qi
Nephrology
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Manifestations of recovery from nephrotic syndrome

In principle, there is no concept of complete recovery for nephrotic syndrome. The condition of nephrotic syndrome can be alleviated and controlled to the greatest extent, but it cannot be completely cured. When the condition is alleviated, the patient's glomerular filtration barrier is repaired, resulting in a reduction in proteinuria and a decrease in urinary foam clinically. Once the patient's urinary protein decreases, the plasma protein concentration will gradually increase. Thus, water moves back from outside to inside the blood vessels, leading to a reduction in edema. These clinical signs all indicate an improvement in the condition of nephrotic syndrome. Of course, to assess the condition, it is still necessary to rely on the patient undergoing a 24-hour quantitative urine protein test.

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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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How long will it take for nephrotic syndrome to get better?

Most cases of nephrotic syndrome are primary nephrotic syndrome, which refers to the absence of specific causes and may be related to immune dysfunction. The disordered immune system attacks the glomerular capillaries causing damage to the filtration barrier, resulting in the patient excreting large amounts of urinary protein. For primary nephrotic syndrome, treatment generally involves the use of corticosteroids or a combination of hormones and immunosuppressants. About 50-60% of patients respond effectively to the medication, which typically takes about two months to take effect. Patients who respond quickly might see effects within one to two weeks, while those with less sensitivity to the medication may need three to four months. The general course of medication is about one year.

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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.