Simultaneous improvement of minimal-change nephrotic syndrome and anemia with steroid therapy

A 56-year-old man presented with transient anemia in minimal-change nephrot ic syndrome. Following nephrotic syndrome, anemia suddenly appeared without renal dysfunction, The anemia might be attributable to hemodilution becaus e of significant correlations between the values of hemoglobin concentratio n and serum total protein or blood urea nitrogen during the clinical course . A low serum level and a low urinary excretion of erythropoietin were foun d, and when nephrotic syndrome ameliorated with steroid therapy, urinary er ythropoietin excretion and anemia disappeared. This case indicated disappea rance of the exponential increase of endogenous erythropoietin in acute ane mia in nephrotic syndrome probably due to urinary losses and altered biosyn thesis of erythropoietin. We report a case of the simultaneous improvement of both nephrotic syndrome and anemia with steroid therapy.