Conditions for discontinuing medication for nephrotic syndrome

Written by Li Liu Sheng
Nephrology
Updated on March 31, 2025
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The main clinical manifestations of nephrotic syndrome are significant proteinuria and hypoproteinemia, along with varying degrees of hyperlipidemia and edema. Nephrotic syndrome often requires treatment with corticosteroids. The general principle for using steroids is to start with a sufficient dosage and administer it slowly, maintaining it for a long duration, approximately around one year. Therefore, the conditions for discontinuing medication in nephrotic syndrome include: if the patient has been treated with steroids for about a year, and the proteinuria has resolved, 24-hour urinary protein quantification is normal, there is no edema, blood albumin levels have returned to normal, and kidney function is also normal, then discontinuation of steroid treatment can be considered. Of course, after stopping the medication, it is essential to regularly visit the hospital for monitoring of routine urine tests, kidney function, and blood pressure to prevent the recurrence of nephrotic syndrome due to infections or fatigue.

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Written by Zhou Qi
Nephrology
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Causes of edema in nephrotic syndrome

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
Nephrology
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Syndrome of kidney disease with manifestations of calcium deficiency

In the state of nephrotic syndrome, if there is a calcium deficiency, it may cause the patient's limbs to twitch, especially sudden twitches and pain in both lower limbs during sleep at night, waking the patient from sleep. If calcium deficiency persists for a long time, it may lead to osteoporosis in the patient, such as osteoporosis of the femoral head, which presents with hip pain, and necrosis of the femoral head, potentially affecting the patient's ability to walk. In children, calcium deficiency may cause night-time convulsions, and external manifestations such as hunchback, pigeon chest, and square skull might appear.

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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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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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Written by Li Liu Sheng
Nephrology
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Conditions for discontinuing medication for nephrotic syndrome

The main clinical manifestations of nephrotic syndrome are significant proteinuria and hypoproteinemia, along with varying degrees of hyperlipidemia and edema. Nephrotic syndrome often requires treatment with corticosteroids. The general principle for using steroids is to start with a sufficient dosage and administer it slowly, maintaining it for a long duration, approximately around one year. Therefore, the conditions for discontinuing medication in nephrotic syndrome include: if the patient has been treated with steroids for about a year, and the proteinuria has resolved, 24-hour urinary protein quantification is normal, there is no edema, blood albumin levels have returned to normal, and kidney function is also normal, then discontinuation of steroid treatment can be considered. Of course, after stopping the medication, it is essential to regularly visit the hospital for monitoring of routine urine tests, kidney function, and blood pressure to prevent the recurrence of nephrotic syndrome due to infections or fatigue.