What Are the Manifestations and Causes of Primary Nephrotic Syndrome? How Can It Be Treated?

Primary nephrotic syndrome can seriously affect daily life. Therefore, once diagnosed with this syndrome, it is important to seek prompt medical attention, as failure to do so may have significant negative impacts on physical health. Many people may not have heard of primary nephrotic syndrome. Before initiating treatment, it is crucial to have a clear understanding of the symptoms and causes of this syndrome, as targeted treatment can effectively manage the condition.

Manifestations and Causes of Primary Nephrotic Syndrome

Manifestations:

1. Discolored urine: Urine may appear dark, cloudy, or with a reddish tint. Immediate medical attention is advised in such cases.
2. Abnormal urine volume: Normal urine output averages 1500 milliliters per day, with 4-8 urinations. Sudden changes in urine volume, without factors like fever, excessive sweating, or increased fluid intake, may indicate kidney dysfunction.
3. Nocturia: Normal individuals below 60 years of age typically do not have nocturnal urination. Increased nocturia in younger individuals may be an early sign of kidney dysfunction.
4. Edema: Edema, or swelling, may occur in the eyelids or face in the morning, often resolving in the afternoon. It may worsen after exertion and improve with rest. Severe edema may affect the ankles, lower legs, and lower back.
5. Back pain: Unexplained back pain should prompt an examination of the kidneys, spine, and back muscles.

Causes:

1. Secondary causes refer to nephrotic syndrome arising from other diseases. A wide range of conditions, including diabetes, systemic lupus erythematosus, multiple myeloma, allergic purpura, medications, toxins, amyloidosis, and genetic diseases, can lead to nephrotic syndrome. Therefore, upon diagnosis of nephrotic syndrome, clinicians must conduct further investigations to identify the underlying cause.
2. Primary causes are attributed to inherent kidney issues rather than other diseases. It is important to exclude secondary causes when diagnosing primary nephrotic syndrome.

Treatment Options for Primary Nephrotic Syndrome

1. Short-term treatment involves oral administration of prednisone at 2 milligrams per day for 4 weeks, or until proteinuria resolves, followed by a reduction to 1 milligram per day every other morning. Treatment is discontinued after 8 weeks.
2. Medium-term therapy involves oral prednisone at 2 milligrams per day for up to 6 weeks, followed by a reduction to 2 milligrams every other morning for 4 weeks. Gradual tapering continues until treatment cessation, with a total duration of at least 6 months.
3. Long-term therapy involves oral prednisone at 2 milligrams per day for up to 8 weeks, followed by a reduction to 2 milligrams every other morning. Gradual tapering continues until treatment cessation, with a total duration of 9 to 12 months.