The main cause of edema in nephrotic syndrome is hypoalbuminemia, and treatment requires protein supplementation and diuretics. Hypoalbuminemia leads to a decrease in plasma colloid osmotic pressure, causing fluid to leak from blood vessels into the interstitial space, resulting in edema.
1. Hypoproteinemia is the core cause of edema in nephrotic syndrome. In patients with nephrotic syndrome, damage to the glomerular filtration membrane leads to significant protein loss in the urine, resulting in a marked decrease in plasma albumin levels. Plasma albumin is a major component in maintaining plasma colloid osmotic pressure; its reduction causes fluid extravasation from blood vessels, triggering edema.
2. Protein supplementation is a key measure to improve hypoalbuminemia. Increasing the intake of high-quality protein in the diet, such as eggs, fish, and soy products, helps to raise plasma albumin levels. For patients with severe hypoalbuminemia, doctors may recommend intravenous infusion of albumin preparations to quickly replenish protein.
3. Diuretics are commonly used medications to relieve edema. Diuretics such as furosemide, torasemide, and hydrochlorothiazide can promote the kidneys to excrete sodium and water, thus reducing edema symptoms. Electrolyte balance should be monitored when using diuretics to avoid side effects such as hypokalemia.
4. Controlling the primary disease is fundamental to preventing edema recurrence. Treatment of nephrotic syndrome needs to target the underlying cause, such as using glucocorticoids like prednisone or immunosuppressants like cyclophosphamide to control the immune response and reduce protein loss.
5. Lifestyle modifications can help manage edema in the long term. Limiting sodium intake and avoiding high-sodium foods such as pickled and processed foods can reduce fluid retention. Moderate exercise, such as walking and yoga, can promote blood circulation and reduce edema.
Treatment for edema caused by nephrotic syndrome requires a focus on protein supplementation, diuretic use, and control of the underlying disease, combined with lifestyle modifications to effectively alleviate symptoms and prevent recurrence. Patients should regularly monitor their renal function and plasma albumin levels to adjust their treatment plan promptly and ensure long-term health management.