Is nephrotic syndrome prone to recurrence?

Written by Zhou Qi
Nephrology
Updated on September 18, 2024
00:00
00:00

Nephrotic syndrome is characterized by more than 3.5 grams of proteinuria in 24 hours and a serum albumin concentration lower than 30 grams per liter. Treatment of this disease should be aimed at the cause, with most patients suffering from primary nephrotic syndrome related to immune dysfunction, therefore often requiring treatment with steroids. Indeed, some patients easily experience relapses; after a period of steroid treatment, proteinuria may decrease or even turn negative. However, upon cessation of the medication or during occurrences like a cold, some patients may suffer from relapses. Not all patients respond this way, as some are dependent on steroids.

Other Voices

doctor image
home-news-image
Written by Zhou Qi
Nephrology
44sec home-news-image

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
40sec home-news-image

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.

doctor image
home-news-image
Written by Zhang Hui
Nephrology
56sec home-news-image

What tests are conducted for nephrotic syndrome?

Patients with nephrotic syndrome need to complete routine urine tests, 24-hour urine protein quantification, liver and kidney function tests, routine blood tests, electrolyte panels, blood glucose tests, and lipid profiles. Additionally, it is important to determine the cause of nephrotic syndrome, excluding the possibility of nephrotic syndrome caused by immune system diseases, including tumors, vasculitis, lupus, and other diseases. These tests include rheumatoid immune panels, antinuclear antibody spectrum, anti-GBM antibodies, ANCA panel, and immunoglobulins. Moreover, these patients should undergo kidney ultrasound, tumor marker tests, and thyroid function tests.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
53sec home-news-image

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
52sec home-news-image

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.