One question is frequently asked by nephrotic syndrome (NS) patients

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One question is frequently asked by nephrotic syndrome (NS) patients, namely, why their disease is prone to relapse, which would cause difficulty in the treatment. Many factors may cause the relapse of primary nephrotic syndrome, including too short steroid treatment period, rapid tapering off the dose of prednisone and infection, etc.
1. certain gene
This recurrence is closely related to leukocyte antigen, which is determined by heredity, namely, it is congenital.
2. Long term use of prednisone
In order to control proteinuria, nephrotic syndrome patients often take steroids and immunosuppressants. Those who have taken prednisone are easy to have atrophic cortex on adrenal gland.This leading to shortage of hormones, which is easy to include the recurrence of nephrotic syndrome.
3. Malpractice of medicines
Some patients reduce the dosage of steroids freely, when they see relieved steroids. This is very likely to cause relapse.
4. Infection
There is a close relation between the relapse nephrotic syndrome and infection,especially upper respiratory. A common cold may result in negative protein, and may also cause swelling.When cold disappear,protein will not be seen in urine.In some serious condition,patients need large dosage of steroids.However, long term and large dosage of steroids can cause burden the kidneys because they will produce many wastes discharged by the kidneys.
5. Massive proteinuria
In nephrotic syndrome, severe proteinuria is the major problem and when it is cured,other symptoms like swelling, hypoproteinemia and hyperlipemia get alleviated naturally.Steroid medicines like prednisone are very helpful in treating nephrotic syndrome, because they contribute to the consumption of protein in the body.On this basis,having a low-protein diet helps to reduce protein in urine.Therefore, we can get effective therapeutic effect with steroid treatment.However, the problem is as damaged kidney is not repaired, when the patients stop taking medicines or reduce medicines, illness relapses.

In nephrotic syndrome, protein leaks into urine due to damaged glomerular filtration membrane.This filtration membrane is of charge barrier and mechanical barrier,which allows very small amount of protein with small molecular weight to pass through.Therefore, normally, protein lost in urine in 24hours is less than 150mg.In nephrotic syndrome, damaged glomerular filtration membrane is damaged and when protein pass through it, they leak into urine,leading to proteinuria.In such a case, the permanent solution is to repair damaged filtration membrane and only in this way, can the relapse of illness be avoided.

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