How to reduce swelling in the feet caused by nephrotic syndrome?

Written by Li Liu Sheng
Nephrology
Updated on November 12, 2024
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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 Wu Ji
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What is nephrotic syndrome?

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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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.

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Causes of vomiting in nephrotic syndrome

Patients with nephrotic syndrome may experience vomiting for several possible reasons. First, nephrotic syndrome causes severe edema in patients, including edema of the gastrointestinal tract. This state of edema may lead to reduced gastrointestinal motility and symptoms of nausea and vomiting. Furthermore, patients with nephrotic syndrome have low plasma protein levels and poor immune function, making them prone to infections. If there is an infection in the gastrointestinal tract, patients may exhibit clinical symptoms of vomiting as well as potentially experiencing diarrhea, abdominal pain, and so on. Additionally, some patients experience vomiting due to the side effects of medications used during the treatment of nephrotic syndrome.

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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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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.