How is nephrotic syndrome diagnosed?

Written by Zhou Qi
Nephrology
Updated on September 28, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Niu Yan Lin
Nephrology
42sec home-news-image

Does nephrotic syndrome require a puncture?

Nephrotic syndrome is a complex of clinical symptoms with various causes, which differ by age group. In children or adolescents, if it presents solely as significant proteinuria without elevated creatinine or hematuria, it is generally caused by minimal change disease. Since this type of kidney disease is sensitive to hormone treatment, it is usually possible to forego renal biopsy and start with corticosteroid therapy. For other nephrotic syndrome patients, it is advisable to first perform a renal biopsy to identify the pathological cause before considering appropriate treatment with hormones, immunosuppressants, and other medications.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
56sec home-news-image

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.

doctor image
home-news-image
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.

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
46sec home-news-image

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.