Manifestations of recovery from nephrotic syndrome

Written by Zhou Qi
Nephrology
Updated on February 22, 2025
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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 Zhu Wei
Nephrology
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What should not be eaten with nephrotic syndrome?

Patients with nephrotic syndrome, if the patient has obvious edema, should limit salt intake to between two to three grams per day. It is suggested to consume foods rich in polyunsaturated fatty acids, such as vegetable oils, as well as foods rich in soluble fiber, such as oats. They should also receive a normal amount of 0.8 to 1 gram of high-quality protein per kilogram of body weight per day, mainly from egg whites, milk, lean meat, and fish. Calorie intake should be sufficient, and patients with nephrotic syndrome should eat less salty and pickled foods and consume less animal fat.

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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 Hu Lin
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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Why does nephrotic syndrome cause sleepiness?

Excessive sleepiness is not a common clinical manifestation of nephrotic syndrome; generally, patients with nephrotic syndrome rarely exhibit excessive sleepiness. If a patient does display sleepiness, it is necessary to investigate the causes, such as a reduction in blood volume and decreased blood pressure caused by nephrotic syndrome, leading to insufficient cerebral blood supply. Furthermore, in cases of nephrotic syndrome, the patient’s immune capacity decreases, making them more susceptible to various infections, such as infections of the upper respiratory tract and lungs. When inflamed, patients are also likely to feel excessively sleepy. In some patients, there is a risk of cerebral infarction, which can also cause sleepiness.

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Written by Zhou Qi
Nephrology
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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.