Precursors of relapse of nephrotic syndrome

Written by Zhou Qi
Nephrology
Updated on December 14, 2024
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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 Zhang Hui
Nephrology
1min 17sec home-news-image

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 Hu Lin
Nephrology
1min 19sec home-news-image

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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Written by Zhou Qi
Nephrology
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Syndrome of kidney disease with manifestations of calcium deficiency

In the state of nephrotic syndrome, if there is a calcium deficiency, it may cause the patient's limbs to twitch, especially sudden twitches and pain in both lower limbs during sleep at night, waking the patient from sleep. If calcium deficiency persists for a long time, it may lead to osteoporosis in the patient, such as osteoporosis of the femoral head, which presents with hip pain, and necrosis of the femoral head, potentially affecting the patient's ability to walk. In children, calcium deficiency may cause night-time convulsions, and external manifestations such as hunchback, pigeon chest, and square skull might appear.

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Written by Zhang Hui
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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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.