Causes of edema in nephrotic syndrome

Written by Zhou Qi
Nephrology
Updated on September 04, 2024
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Edema is a diagnostic criterion for nephrotic syndrome, as well as a major clinical symptom and characteristic of the syndrome. There are several reasons why patients develop edema.

First, a large amount of protein leaks out from the kidneys, causing a decrease in the concentration of plasma albumin and a decrease in the colloid osmotic pressure in the plasma, which makes it easy for water to move from inside the blood vessels to outside, causing edema.

Second, patients with nephrotic syndrome have increased vascular permeability, which also makes it easy for water to enter the interstitial tissues. Among patients with nephrotic syndrome, some are prone to acute renal failure, which further decreases the kidney's ability to excrete water, and these factors together lead to the common occurrence of edema in patients.

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Written by Zhou Qi
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Is nephrotic syndrome prone to recurrence?

Nephrotic syndrome is characterized by more than 3.5 grams of proteinuria in 24 hours and a serum albumin concentration lower than 30 grams per liter. Treatment of this disease should be aimed at the cause, with most patients suffering from primary nephrotic syndrome related to immune dysfunction, therefore often requiring treatment with steroids. Indeed, some patients easily experience relapses; after a period of steroid treatment, proteinuria may decrease or even turn negative. However, upon cessation of the medication or during occurrences like a cold, some patients may suffer from relapses. Not all patients respond this way, as some are dependent on steroids.

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Written by Zhang Hui
Nephrology
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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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Written by Zhou Qi
Nephrology
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Can nephrotic syndrome be clinically cured?

Nephrotic syndrome, a disease that clinically cannot be completely cured, is a chronic illness with no concept of cure. However, with appropriate treatment plans, many patients can achieve effective relief. There are two criteria for judging treatment effectiveness: first, the patient's 24-hour urinary protein quantification is controlled below 0.5 grams, and even can be controlled below 0.3 grams. Second, the patient's 24-hour urinary protein quantification is reduced by more than half compared to the baseline value. Both scenarios indicate effective treatment, but achieving a complete cure is difficult.

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Written by Niu Yan Lin
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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Nephrotic syndrome urine output

Patients with nephrotic syndrome vary in the amount of urine they produce. Some patients have normal urine output and may not exhibit obvious symptoms of edema, but others may have reduced urine output, which can even lead to acute renal failure. Nephrotic syndrome emphasizes that the glomerular filtration barrier is damaged, resulting in a large amount of urinary protein, with a 24-hour urinary protein quantitative exceeding 3.5 grams. This situation highlights the decreased ability of the filtration barrier to retain proteins in the blood, meaning the integrity of the filtration barrier is compromised. However, the kidney's ability to excrete water and metabolic waste is not indicated by the term "nephrotic syndrome" itself, thus the patient's urine output can vary.