Immunotherapy for Treating Nephrotic Syndrome

The onset of nephrotic syndrome is related to immune reactions and inflammatory reactions.

First I will explain its pathogenesis from the perspective of immunology. Due to disorder and dysfunction in the immune system, immune complexes will form and they will circulate in the blood and deposit in the kidneys. As a result, mononuclear macrophage, neutrophils, platelet and inflammatory medium will invade the kidneys aiming at removing these immune complexes.

However at the same time of fighting against immune complexes, the renal intrinsic cells and tissues will be damaged too. If the immune and inflammatory reactions can not be solved for a long time, the charge barrier and mechanical barrier will be damaged and there will be proteins leaked out and when its amount excess the renal tubular re-absorption ability, there will be proteinuria in clinic.

Effective treatments for nephrotic syndrome should achieve the following effects---eliminating underlying causes and inducing factors, relieving edema, proteinuria and high blood pressure, improving plasma albumin, reducing hyperlipidemia, protecting kidney functions and preventing relapse.

To make it simple, immunotherapy is the combination of Chinese and western therapies.

Western therapy mainly adopts hormones and cytotoxic medicines. Hormones such as glucocorticoid have the functions of inhibiting inflammatory and immune reactions as well as the secretion of aldosterone and vasopressin so as to achieve the effects of alleviating proteinuria and diuresis. Cytotoxic medicines such as cyclophosphamide, cyclosporine and tacrolimus can be applied to the following cases---hormones have no effects, patients have become dependent on hormones, severe illness conditions or have frequent relapsing.

The combination of some Chinese medicines can help lessen discomforts and side effects of hormones and cytotoxic medicines. For example, tripterygium wilfordi is a good immunosuppressant in Chinese medicines and astragalus can help increase the albumin synthesis in the liver, etc.

While taking medicines, weather it is Chinese or western medicines, patients should under the doctors’ guidance and supervision because improper intake of some medicines can poison the kidneys and some medicines might have reactions with others.

Besides proper treatments, nephrotic syndrome patients should have adequate rest and the daily diets should be high-quality protein (1g/kg/d) and high-calories (30-50Kcal/kg/d), low-salt, low-fat.