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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Is nephrotic syndrome contagious?

So, nephrotic syndrome is a general term for a group of clinical symptoms, a state of disease, and is not essentially an independent disease. Thus, this problem is not infectious. This disease describes the damage to the kidneys due to some reason, leading to the disruption of the integrity of the glomerular filtration barrier, resulting in the patient developing a significant amount of urinary protein. The disease itself is not contagious. However, there are very few cases of nephrotic syndrome that might be caused by hepatitis B virus infecting the kidneys. In such cases, the hepatitis B virus may have a certain level of contagiousness, but even so, it does not imply that nephrotic syndrome itself is contagious. In other words, even if such patients transmit hepatitis B to others, it does not necessarily mean those others will exhibit kidney damage.

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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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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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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
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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.