What to do if nephrotic syndrome causes leg pain?

Written by Zhou Qi
Nephrology
Updated on September 26, 2024
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Patients with nephrotic syndrome who experience leg pain mostly have conditions unrelated to nephrotic syndrome itself. It could be due to diseases of the skeletal or muscular system. However, some patients might experience leg pain due to thrombosis caused by nephrotic syndrome, leading to ischemia in the limbs. Also, long-term use of corticosteroids can lead to necrosis of the femoral head, osteoporosis, and pain. Therefore, treatment should be targeted based on the cause, such as using drugs to dissolve clots or interventional surgery for those with thrombosis. In severe cases of femoral head necrosis, a femoral head replacement surgery might be necessary, and it is important to supplement with calcium regularly.

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Written by Zhou Qi
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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How long will it take for nephrotic syndrome to get better?

Most cases of nephrotic syndrome are primary nephrotic syndrome, which refers to the absence of specific causes and may be related to immune dysfunction. The disordered immune system attacks the glomerular capillaries causing damage to the filtration barrier, resulting in the patient excreting large amounts of urinary protein. For primary nephrotic syndrome, treatment generally involves the use of corticosteroids or a combination of hormones and immunosuppressants. About 50-60% of patients respond effectively to the medication, which typically takes about two months to take effect. Patients who respond quickly might see effects within one to two weeks, while those with less sensitivity to the medication may need three to four months. The general course of medication is about one year.

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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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Nephrology
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Characteristics of Nephrotic Syndrome

The characteristic feature of nephrotic syndrome is that patients may experience edema, which is related to the nature of this disease. The essence of this disease is due to some reason that damages the glomerular capillary filtration barrier. As a result, when blood passes through the glomeruli, it leaks proteins from the blood. A 24-hour urinary protein quantification will exceed 3.5 grams, which constitutes a large amount of urinary protein. Consequently, a large amount of protein is leaked into the urine, causing the protein concentration in the plasma to decrease. This leads to a reduction in the colloidal osmotic pressure of the plasma, causing fluid to move from inside the blood vessels to outside, thus leading to edema. Therefore, the most significant clinical feature of nephrotic syndrome is the potential to cause edema, and severe cases of edema may elevate blood pressure, lead to pulmonary edema, manifesting as difficulty breathing, chest tightness, and shortness of breath.

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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.