Conditions for discontinuing medication for nephrotic syndrome

Written by Li Liu Sheng
Nephrology
Updated on March 31, 2025
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The main clinical manifestations of nephrotic syndrome are significant proteinuria and hypoproteinemia, along with varying degrees of hyperlipidemia and edema. Nephrotic syndrome often requires treatment with corticosteroids. The general principle for using steroids is to start with a sufficient dosage and administer it slowly, maintaining it for a long duration, approximately around one year. Therefore, the conditions for discontinuing medication in nephrotic syndrome include: if the patient has been treated with steroids for about a year, and the proteinuria has resolved, 24-hour urinary protein quantification is normal, there is no edema, blood albumin levels have returned to normal, and kidney function is also normal, then discontinuation of steroid treatment can be considered. Of course, after stopping the medication, it is essential to regularly visit the hospital for monitoring of routine urine tests, kidney function, and blood pressure to prevent the recurrence of nephrotic syndrome due to infections or fatigue.

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Kidney disease syndrome is classified as what disease?

Nephrotic syndrome is a clinical subtype of chronic kidney disease. It can be diagnosed when there is significant proteinuria, hypoalbuminemia, accompanied by edema and hyperlipidemia. This represents a severe stage in the progression of kidney diseases, generally requiring treatment with steroids and immunosuppressants. Nephrotic syndrome may have complications such as thrombosis, infections, hyperlipidemia, and acute renal failure.

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Is nephrotic syndrome easy to treat in children?

The diagnostic criteria for nephrotic syndrome are a 24-hour urinary protein quantification exceeding 3.5g and plasma albumin levels below 30g/l. This is due to severe damage to the glomerular capillary network, which has many pathological types since there are various components to the glomerular capillaries, and damage to different components is referred to as different pathological types. Among children, the most common pathological types are minimal change disease and mesangial proliferative glomerulonephritis. These two types are relatively easier to treat. Most children are sensitive to steroid medication. However, treatment becomes difficult with other pathological types, such as focal segmental glomerulosclerosis, which shows less sensitivity to steroids. (Medication use should be under the guidance of a doctor.)

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How is nephrotic syndrome diagnosed?

Nephrotic syndrome is a general term for a group of clinical symptoms. Its primary diagnostic criteria include a 24-hour urine protein quantification of greater than or equal to 3.5 grams and plasma albumin less than or equal to 30 grams per liter; these two criteria are essential for the diagnosis of nephrotic syndrome. Meeting these criteria is sufficient for the diagnosis. There are also two additional supporting diagnostic criteria for nephrotic syndrome, which include possible symptoms of edema and hyperlipidemia. These four elements are the main clinical manifestations and diagnostic criteria of nephrotic syndrome.

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Is nephrotic syndrome contagious?

So, nephrotic syndrome is a general term for a group of clinical symptoms, a state of disease, and is not essentially an independent disease. Thus, this problem is not infectious. This disease describes the damage to the kidneys due to some reason, leading to the disruption of the integrity of the glomerular filtration barrier, resulting in the patient developing a significant amount of urinary protein. The disease itself is not contagious. However, there are very few cases of nephrotic syndrome that might be caused by hepatitis B virus infecting the kidneys. In such cases, the hepatitis B virus may have a certain level of contagiousness, but even so, it does not imply that nephrotic syndrome itself is contagious. In other words, even if such patients transmit hepatitis B to others, it does not necessarily mean those others will exhibit kidney damage.

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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.