Patient's question:
I have mild lesions of nephrotic syndrome and am currently taking 4 hormone pills. Can I engage in running exercises?Doctor's answer:
Treatment of nephritis, common drugs and their side effects for nephrotic syndrome: Corticosteroids such as dexamethasone, prednisone, and cortisol are commonly used. The side effects include:1. Can cause disorders in water, salt, sugar, protein, and fat metabolism, water and sodium retention, leading to central obesity, moon face, thinning skin, striae, muscle weakness, hypokalemia, edema, hypertension, acne, hirsutism, and other symptoms. When using hormones, a low-sodium, low-sugar, high-protein diet is recommended to alleviate symptoms.
2. Corticosteroids can also cause steroid-induced diabetes, reduce glucose tolerance, and inhibit the reabsorption and utilization of glucose by renal tubules, leading to elevated blood sugar and diabetes.
3. Muscle atrophy, osteoporosis, and severe cases may lead to avascular necrosis of the femoral head.
4. Can induce and exacerbate infections; corticosteroids also lower immunity, favoring bacterial growth, proliferation, and spread, thereby inducing and worsening infections. They also have teratogenic effects on fetuses. Clinically, low-protein edema caused by protein loss in nephrotic syndrome is often confused with edema caused by sodium and water retention due to hormones.
The side effects of cyclophosphamide include: bone marrow suppression, leukopenia, decreased immunity, liver and kidney damage, urinary system symptoms, and 5–15% of patients may experience proteinuria, hematuria, bladder bleeding, hair loss, and reduced sperm vitality. Regular liver and kidney function tests are required during treatment. Those who are childless and pregnant women should not use it.
The side effects of total tripterygium glycosides include: menstrual disorders, reduced sperm vitality and quantity, nausea, vomiting, abdominal pain, diarrhea, decreased appetite, and lowered immunity, leading to leukopenia and thrombocytopenia.
### Contradictions Between Clinical Medicine and Renal Physiology
Western medicine considers the physiological functions of the kidneys to include: filtering urea, creatinine, uric acid, creatine, and some acidic substances to form urine and excrete them; regulating acid-base balance; producing physiological active substances such as renin, bradykinin, prostaglandins, and erythropoietin 1,25-dihydroxyvitamin D3 to regulate blood pressure; and inactivating hormones such as gastrin, insulin, and parathyroid hormone.
Traditional Chinese medicine (TCM) believes that the kidneys are the foundation of life, store essence, govern bones and marrow, and their essence manifests in hair; they control fluid metabolism, the life gate fire, and open into the ears, governing urination and defecation. TCM also considers renal functions to include sexual function, immune function, metabolic function, and even human lifespan.
After developing nephritis or nephrotic syndrome, patients may experience low-protein edema due to protein loss, hypertension caused by immune complexes, and hematuria. Corticosteroids can cause sodium and water retention, leading to hypertension; cyclophosphamide can damage liver and kidney function, causing proteinuria and hematuria; and total tripterygium glycosides can lead to menopause and reduced sperm vitality. All three drugs are harmful to the kidneys. If the kidneys are already diseased, why should these drugs still be used?
### Contradictions Between Cellular Immunology and Clinical Medication
The cause of nephritis is bacterial, viral infections, or allergens that trigger allergies, produce antigens, and form immune complexes (ICs). ICs can be phagocytosed by phagocytes or activate complement enzymes through immune reactions, leading to the degradation of ICs. When the immune response is suppressed, complement enzymes cannot be activated promptly, failing to degrade ICs. In this case, ICs accumulate in renal cells, leading to the formation of nephritis and nephrotic syndrome.
Kidney biopsy pathology results can confirm this: unactivated complement enzymes C3 and C4 are often accompanied by IC deposition in glomerular cells.
Corticosteroids and cyclophosphamide suppress the immune response, inhibit the expression and activation of complement enzymes, reduce immunity, and exacerbate infections, leading to the formation of new ICs and worsening nephritis and nephrotic syndrome. This creates a vicious cycle, ultimately resulting in renal failure due to drug damage.
Based on cellular immunology research and kidney biopsy results, the cause of nephritis is ICs formed during infections. Corticosteroids cannot directly or indirectly degrade ICs and may even indirectly increase ICs, worsening nephritis.
### Contradictions Between Nephropathology and Medication
The kidneys are important metabolic organs in the human body. When pathological changes occur in the kidneys, their metabolic functions become abnormal. Any food or drug entering the body must be detoxified by the liver and excreted by the kidneys. The more drugs are used, the greater the burden on the kidneys for detoxification. When using drugs such as corticosteroids, total tripterygium glycosides, and cyclophosphamide, additional calcium supplements, antihypertensive drugs, and immune-boosting medications are often required to mitigate side effects, further straining the liver and kidneys.
### Contradictions in Clinical Medication
Clinically, immune enhancers such as Jin Shui Bao capsules and Huang Qi injections are often combined with immunosuppressants like corticosteroids, total tripterygium glycosides, and cyclophosphamide.
We know that chemical drugs have compatibility restrictions, and traditional Chinese medicine (TCM) also has the "Eighteen Contradictions" and "Nineteen Mutual Antagonisms." Can TCM and Western medicine be used freely together? Combining immune enhancers with immune suppressants is immune regulation? Clearly, this is due to unclear treatment methods and medication principles, merely aiming to temporarily control clinical symptoms, leading to incorrect drug combinations.
### Summary
In recent years, the clinical use of long-acting corticosteroids such as dexamethasone to treat upper respiratory tract infections has led to a continuous rise in the incidence of nephritis, diabetes, and hypertension. For years, our textbooks such as Internal Medicine and Nephrology have recommended immunosuppressive therapy for nephritis and nephrotic syndrome, using immunosuppressants to inhibit immune responses and reduce immunity.
Combining knowledge from Pharmacology, Molecular and Cellular Immunology, and Pathology regarding nephritis reveals that: even though it is known that inhibiting immune responses with immunosuppressants only controls symptoms and can only be used in acute phases to achieve 15–30% clinical success, they are still used in large quantities. Even if acute nephritis patients are cured, the recurrence rate within 20 years is still over 85%. Chronic nephritis patients with symptoms lasting over six months should absolutely not use immunosuppressants. We believe that these highly toxic immunosuppressants and cytotoxic drugs have led to decreased immunity, worsened nephritis, and eventual renal failure in chronic nephritis patients.
In the treatment of nephritis, we adopt the opposite approach by enhancing immunity, strengthening immune responses, and activating complement enzymes to degrade ICs. We use immune enhancers such as Huang Qi injections and lentinan injections, combined with traditional Chinese medicine formulas including Cordyceps sinensis, Huang Qi, Rehmannia glutinosa, Angelica sinensis, Cicinnedia sinensis, Uncaria gambir, Schisandra chinensis, Plantago asiatica, Echinacea purpurea, Poria cocos, and Glycyrrhiza uralensis. Statistics show that both acute and chronic nephritis achieve over 85% success rates, with clinical follow-up indicating that after recovery, recurrence-free periods can last over 40 years.