Nephrotic syndrome complicated by hyperlipidemia Drug guidance:
Proteinuria (quantitative urinary protein >3.5 grams/day), decreased plasma albumin (plasma albumin <30 grams/liter), edema, and elevated blood lipids are typical clinical manifestations of nephrotic syndrome. Nephrotic syndrome is more commonly seen in glomerular diseases. The adequacy of treatment for nephrotic syndrome directly affects the prognosis of patients. The most common complication in patients with nephrotic syndrome is hypercholesterolemia, with elevated low-density lipoprotein-cholesterol being the main lipid metabolism abnormality.
In mild cases, serum triglyceride levels may be normal, with only an increase in serum cholesterol levels. In moderate cases, both serum cholesterol and triglyceride levels are elevated. Generally, the degree of increase in serum total cholesterol levels is inversely proportional to the serum albumin content. When the serum albumin content is below 30 grams/liter, severe hypercholesterolemia can occur. However, in severe cases of nephrotic syndrome (serum albumin content below 10 grams/liter), the increase in serum cholesterol levels is not significant, but there is a predominant elevation in triglyceride levels. This may be related to decreased lipoprotein lipase activity.
Research has shown that renal lipid metabolism disorders increase the risk of coronary heart disease. Therefore, in the presence of persistent hyperlipidemia, in addition to specific treatment for nephrotic syndrome, lipid-lowering drugs that can reduce cholesterol should also be used. Statin drugs such as pravastatin and simvastatin are preferred. The recommended dosage is 20 milligrams of pravastatin, 1-2 times daily, and 10-40 milligrams of simvastatin, 1-2 times daily. Common adverse reactions include muscle pain, gastrointestinal symptoms, insomnia, rash, and elevated transaminase levels.
