First, we should figure out what nephrotic syndrome is. It refers to larger amount of proteinuria (>3.5g/day for adult, 50mg for children), hypoalbuminemia (< 30g/L), hyperlipidemia and edema which is generalized & also known as anasarca or dropsy. As science developed, it is known that the above symptoms manifested that a patient has damages in glomerular filtration. To be more specific, intrinsic cells and basement membrane that sustain glomerular mechanism barrier and charge barrier are damaged, so that a large amount of protein which should stay in bloodstream leak to nephridial tubules and is beyond the scope of refiltration capability in nephridial tubules, resulting in proteinuria. The amount of protein that synthesized by liver could not compensate for the large loss of protein in bloodstream, which triggers hypoalbuminemia. In that case, insufficient colloid osmotic pressure would lead to a malfunction of holding water. Too much water in tissue spaces will form edema. Therefore, it is easy to conclude that intrinsic cell damages would be the root cause of nephrotic syndrome. Only through repairing the damaged intrinsic cells could symptoms such as proteinuria(Proteinuria and Kidney Disease), hypoalbuminemia, and hyperlipidemia be completely disappeared. Only that accounts for fully recovery.
Why do so many nephrotic syndrome patients suffer the torture of recurrence? Normally, nephrotic syndrome are regarded as immunologic renal disease, because immune responses toward abnormalities will generate large amount of pathogenic immune complex that deposit in glomerulus, cause damages to intrinsic cells and trigger a serious pathological changes like inflammation. In this stage, Intrinsic cells are functionally damaged. Large amount of protein albumin leak due to malfunction of infiltration. ... Therefore, many nephrotic syndrome patients are treated by using immunosuppressive and anti-inflammatory hormones to reduce a continual deposit of pathogenic immune complex and further inflammation. It will relive a further damage of glomerulus and then control the illness.
To be frank, hormones have an obvious effect on proteinuria control. Proteinuria will be alleviated or negative within a very short time by hormone administration. The illness appeared to be controlled well. While, this fragile condition will be easily defeated by a flue attack, a tire caused by a simple labor activity, and so on. Then, proteinuria will flare up, followed by hypoalbuminemia, edema(Swelling and Kidney Disease), etc. To control the illness requires one more time of hormone administration with bigger dose. Control, and then relapse, one after another, what a miserable process. Actually, the etiology of nephrotic syndrome is not that complicated. Beside the deposit of pathogenic immune complex and inflammation responses, many factors would induce damages of intrinsic cells and other tissues in the kidneys including blood and oxygen deficiency in renal tissues, microthrombus caused by hyperfuction of coagulation mechanism, the synthesis of glomerular mesangial cells, degradation unbalance, etc. In order to receive a complete repair of the damaged tissues like intrinsic cells by a comprehensive elimination of so many pathogenic factors, it is far from enough to inhibit immune response and fight against inflamation via hormones. In addition, it is well known that hormones have strong side-effects. So, it is a double-edged sword to use hormones for nephrotic syndrome treatments. No wonder there are frequent relapses, prolonging the illness hardly to be healed. The patients by receiving traditional Chinese medications also have recurrences due to its complicated pathogenesis and slow initial effects of Chinese medications. It is not the Chinese medications that can not defeat the illness but the symptomatic medications are insufficient for a cure.
