Recently, Ms. Huang’s feet have swollen for no apparent reason. The swelling is so severe that her ankles are no longer visible. When a finger is pressed on the swollen area, a pit forms and takes a long time to regain its original shape.
At the hospital, the doctor told Ms. Huang that there are many reasons for swollen feet. Problems with the heart, liver, kidneys, endocrine system, or problems with blood vessels and lymphatic drainage can all cause limb edema.
Based on the results of Ms. Huang’s blood and urine tests, her swollen feet are caused by nephrotic syndrome.
“What kind of disease is nephrotic syndrome?” Ms. Huang anxiously asked the doctor, eager to understand.
What is Nephrotic Syndrome?
Under normal circumstances, the kidneys are like a sieve. They can filter out useless and even harmful substances (metabolic waste) in the blood to form urine and excrete it. At the same time, they can prevent specific substances from passing through and retain the “beneficial” part (albumin) in the blood. In medicine, this sieve is called the “glomerular filtration barrier”.
If this sieve is damaged, the “good” substances (albumin) in the blood will pass through the enlarged sieve holes into the urine, forming “proteinuria”. When the loss of proteinuria reaches a certain level, and the rate of albumin production in the human body “cannot keep up” with the rate of loss through urine, “hypoalbuminemia” will occur. Coupled with some other symptoms, it becomes “nephrotic syndrome”. Seriously speaking, nephrotic syndrome has the following characteristics:
- Heavy proteinuria
- Hypoalbuminemia
- Edema
- Hyperlipidemia
Heavy proteinuria means that the protein content in the urine excreted in 24 hours exceeds 3.5 g, while hypoalbuminemia refers to a serum albumin content in the human body of less than 30 g/L. These two are essential conditions for doctors to diagnose “nephrotic syndrome”.
Why Do You Get Nephrotic Syndrome?
“Why did I get this disease? Did I eat something wrong?” Ms. Huang really felt wronged.
The doctor smiled and comforted Ms. Huang, saying: Nephrotic syndrome is not as simple as eating one or two wrong things. Its causes are generally divided into two categories: primary and secondary.
Primary nephrotic syndrome
Primary nephrotic syndrome means there is something wrong with the kidneys themselves. The glomerular filtration barrier is no longer complete, that is, the filtering sieve is incomplete, and a large amount of protein is excreted through the urine. At present, the medical community is not very clear about the cause of primary nephrotic syndrome.
Secondary nephrotic syndrome
Secondary nephrotic syndrome means that the damage to the kidneys is caused by other factors. Common causes include diabetes, systemic lupus erythematosus, hepatitis B virus infection, drugs, tumors, etc. Patients with the above diseases are more likely to develop nephrotic syndrome.
What Are the Symptoms of Nephrotic Syndrome?
“Why do my feet swell after getting this disease? What other symptoms are there besides swollen feet? Is it serious?” Ms. Huang was very puzzled.
Edema, especially edema of the lower limbs, is the most common symptom in patients with nephrotic syndrome. In addition, there may be limb edema, as well as pleural effusion and ascites.
If patients are more careful when using the toilet, they may also notice the presence of foamy urine.
The so – called “foamy urine” means that there are persistent bubbles in the urine excreted. However, it should be noted that if the bubbles in the urine only exist when the urine is excreted and quickly disappear within dozens of seconds, there is no need to be nervous. Only persistent bubbles indicate the presence of proteinuria.
“Ah, yes! Now that you mention it, I remember. Recently, there have indeed been a lot of bubbles in my urine, and they always don’t disappear in the toilet!” Ms. Huang suddenly realized.
“So how is this disease treated? Just now, I heard a young man say that when he got this disease, he had to take 10 hormones every day at the beginning! Hormones seem really scary. Won’t something go wrong if you take so many? And he said he had a kidney biopsy and they took a bit of his kidney out. It sounds terrifying!” Ms. Huang started a new round of doubts.
How to Treat Nephrotic Syndrome?
“Kidney biopsy is not as scary as you think.” Hearing what Ms. Huang said, the doctor got anxious and quickly explained the legendary kidney biopsy to Ms. Huang, using gestures.
If nephrotic syndrome is compared to a house and the treatment is compared to the decoration plan of the house, then a kidney biopsy is like the process of entering the house to check its internal structure. Only by understanding the specific structure of the “house” can we have a more comprehensive understanding of the illness, and it is also beneficial for formulating a more detailed and individualized treatment plan. Click to view the science article on kidney biopsy.
In terms of treatment, glucocorticoids, as the basic medication for treating nephrotic syndrome, are an inescapable topic. Especially at the beginning of treatment, the dosage of hormones is relatively large, and many patients will experience the following situations:
- Moon face and buffalo hump
- Acne
- Weight gain
- Infection
- Digestive system discomfort
- Osteoporosis
However, as the illness is brought under control, the dosage of hormones will gradually decrease, and the associated side effects will also gradually weaken.
It should be noted that the treatment of nephrotic syndrome is a long battle. During the course of the illness, it is necessary to regularly review and take medications as prescribed by the doctor. Do not reduce the dosage or stop taking the medications on your own! Some patients, after feeling that their symptoms have improved, do not follow the doctor’s advice and change the hormone dosage on their own or even stop taking the medications, resulting in the recurrence of the disease. The consequences are unimaginable.
“It seems that hormone treatment for this disease is quite common. Since so many people have experienced it, I don’t need to be scared either!” A rare smile appeared on Ms. Huang’s face. “So besides taking medications and regularly seeing the doctor to adjust the medications, what else do I need to pay attention to in life? Can I still dance square dance with my sisters?” Ms. Huang asked again.
“I was just about to tell you! You asked, getting ahead of me!” The doctor said with a smile.
What to Pay Attention to in Life When You Have Nephrotic Syndrome?
Exercise
Patients with nephrotic syndrome need to rest more. On the basis of “not feeling tired by themselves”, they should engage in appropriate activities to avoid exacerbating or relapsing the illness due to fatigue or staying up late. And because the albumin level in such patients is low and their resistance is weak, they should appropriately reduce contact with the outside world to prevent cross – infection. So the square dance that Ms. Huang mentioned can be danced, but she must do it according to her ability.
Diet
In terms of diet, one should eat easily digestible, light, and clean foods. Eat less processed foods and reduce the intake of salt and oil to avoid increasing water and sodium retention and blood lipid levels.
In the early stage of the disease, due to a relatively large loss of protein in the urine, an appropriate increase in the intake of high – quality protein can be given. In the later stage of the disease, to slow down the chronic renal function damage related to the disease, a small amount of high – quality protein should be ingested. (Eggs, milk, fish in animal protein and soybean protein are all common high – quality proteins!)
“So, if I exercise appropriately, pay attention to rest, have a light diet, eat less fatty meat, use less salt and oil when cooking, and eat an appropriate amount of high – quality protein such as fish and milk, it doesn’t seem too difficult! With the medications, can this disease be cured?” Ms. Huang asked with anticipation.
“Treating as prescribed by the doctor can control the illness to the greatest extent. At the same time, this disease has a characteristic. Even after the disease is completely controlled, if you’re not careful, there is still a possibility of recurrence.” The doctor said seriously.
“There’s still a possibility of recurrence. Is it still necessary for me to get treated?” Ms. Huang asked in surprise.
“Whether you eat breakfast or not, you’ll be hungry at 12 noon. Does that mean there’s no need to eat breakfast? The same goes for treating an illness. If the disease can be controlled and it doesn’t affect the quality of life, what’s wrong with taking a few medications every day? And Ms. Huang, you’re so careful. I believe you will surely cooperate with the doctor to control the illness to the greatest extent.”
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