Sexual Health
Correctly Understanding Nephrotic Syndrome and Getting Rid of Mistakes as soon as possible
Nephrotic syndrome refers to a group of syndromes caused by multiple causes, mainly characterized by increased glomerular basement membrane permeability and decreased glomerular filtration rate. Nephrotic syndrome is not an independent disease, but a group of symptoms in glomerular diseases, typically characterized by high proteinuria, hypoalbuminemia, high edema, and hyperlipidemia. Nephrology experts point out that many patients have some misconceptions about nephrotic syndrome, leading to delayed treatment and "wasting money".
Myth 1: Primary nephrotic syndrome is an acute disease.
True or False: Primary nephrotic syndrome (referred to as nephrotic syndrome) is a chronic disease. Manifestation is "three highs and one low", which includes high proteinuria, high edema, hyperlipidemia, and hypoproteinemia. Most patients with nephrotic syndrome have no cause of onset, some have a history of allergies (such as allergies to milk, pollen, etc.) or have a recent history of vaccination against the epidemic; Some occur after insect bites, bee stings, etc. Some patients believe that they are usually in good health, but if they suddenly swell up in the past few days, they must have developed an acute disease and will recover in a few days. Actually, it's not the case. Once you have primary nephrotic syndrome, it's a chronic disease.
Myth 2: The more proteinuria, the more obvious the swelling, and the more severe the condition.
True or False: The severity and prognosis of nephrotic syndrome mainly depend on the pathological type. The pathological type can only be determined through renal puncture examination. Some patients may have obvious swelling, but their pathological types are mild, and most are sensitive to hormone therapy, resulting in good therapeutic effects. On the contrary, some patients may not have obvious swelling, but their pathological manifestations may be membranous proliferative nephritis or severe focal segmental glomerulosclerosis. They are not sensitive to hormone therapy and have a poor prognosis. Therefore, for adult patients with nephrotic syndrome, it is best to perform renal biopsy first, clarify the pathological type, and then decide on the treatment plan. To avoid blindly using hormone therapy and causing adverse consequences.
Myth 3: Patients with nephrotic syndrome should receive more albumin transfusions, which is better.
True or False: Actually, transfusing albumin is a waste. Intravenous infusion of albumin will be excreted from the urine through the kidneys within 1-2 days, and can only maintain a short-term therapeutic effect. Albumin infusion is only suitable for two situations: ① patients with nephrotic syndrome have severe systemic edema, and intravenous injection of furosemide cannot achieve diuretic and detumescence effects; ② After using furosemide for diuresis, the patient exhibits insufficient plasma volume. In recent years, studies on patients with nephrotic syndrome have shown that the response to hormone therapy is significantly slower in the plasma protein group compared to the non plasma product group, and the more plasma products are used, the slower the remission of proteinuria. Albumin is expensive, especially long-term infusion of albumin, which can be said to be 'more than worth the loss'.
Myth 4: Sudden cessation of medication when taking hormones.
True or False: The principle of hormone therapy is "to start with sufficient dosage, slow reduction, and maintain for a long time".
Initially treated patients usually start taking prednisone 1mg/kg daily, and after 8 weeks, they need to reduce their dosage by taking one tablet per week. Reduce the dosage to about 0.5mg/kg per day and change it to 2 days of medication, taking it in the morning the next day to reduce adverse reactions to hormones. The smaller the dose, the slower the reduction. When reducing to taking 2 tablets every other day, maintain for 12-18 months. This can reduce the recurrence of nephrotic syndrome syndrome.