What are the Factors Affecting the Prognosis of Nephrotic Syndrome

During the course of nephrotic syndrome, patients will experience progressive decline of urine output and deterioration of renal functions and in the end develop into acute renal failure which is the worst complication of NS and it will increase the difficulty of treatments.

The main factors that can affect the prognosis of nephrotic syndrome include underlying causes, pathological type, clinical manifestations and renal functions.

1. Underlying causes. The prognosis is good if nephrotic syndrome is caused by tonsillitis or hemolytic streptococcus while the prognosis is poor if NS is secondary to systemic diseases such as systemic lupus erythematosus, purpura, etc.

2. Pathological type. Histologically NS can be classified into minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), memebraneous nephropathy (MN) and mesangial proliferative glomerulonephritis (MPGN). Each type has different prognosis. MCD has the best prognosis and 90% to 95% diseased children can have good curative effects while using glucocorticoid for the first time. If there is crescent in renal capsule or there is glomerular sclerosis, it indicates that the lesion is relatively serious and the prognosis is poor.

3. Clinical manifestations. In case of persistent high blood pressure or anemia, the prognosis is poor. If there is only proteinuria or microscopic hematuria or if the blood pressure can be brought under control the prognosis can be better.

4. Renal functions. Nephrotic syndrome will cause damages of the renal tubules due to increased re-absorption of protein. It often manifested as glycosuria, amino acid urine, high phosphate urine, loss of potassium and high chlorine acidosis and it usually indicates poor prognosis. If the renal function is normal or can be recovered the prognosis is good, however if the renal function is severely damaged and the illness has developed in the stage of renal failure the prognosis is poor.

It is not terrible to have disease, what is terrible is to let the disease develop by itself without taking effective measure. Once the NS is diagnosed, patients should take positive and timely actions so as to avoid undesirable prognosis. So long as the underlying causes are removed and the further kidney damage is prevented can patients have a good prognosis.