How to treat anemia in nephrotic syndrome?

Written by Zhou Qi
Nephrology
Updated on September 01, 2024
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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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Written by Zhou Qi
Nephrology
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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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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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Manifestations of recovery from nephrotic syndrome

In principle, there is no concept of complete recovery for nephrotic syndrome. The condition of nephrotic syndrome can be alleviated and controlled to the greatest extent, but it cannot be completely cured. When the condition is alleviated, the patient's glomerular filtration barrier is repaired, resulting in a reduction in proteinuria and a decrease in urinary foam clinically. Once the patient's urinary protein decreases, the plasma protein concentration will gradually increase. Thus, water moves back from outside to inside the blood vessels, leading to a reduction in edema. These clinical signs all indicate an improvement in the condition of nephrotic syndrome. Of course, to assess the condition, it is still necessary to rely on the patient undergoing a 24-hour quantitative urine protein test.

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Written by Zhang Hui
Nephrology
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Characteristics of Nephrotic Syndrome

The characteristics of nephrotic syndrome are defined by significant proteinuria, where significant proteinuria refers to urinary protein exceeding 3.5 grams in 24 hours; hypoproteinemia, which refers to blood albumin levels below 30 grams per liter; edema, which may present in facial and lower limbs, and even severe patients may exhibit generalized edema around both lower limbs; and hyperlipidemia, characterized by increased cholesterol and triglycerides in the blood. These patients may exhibit reduced urine output, edema, and noticeably increased foam in the urine.

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Written by Zhou Qi
Nephrology
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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.)