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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Refractory nephrotic syndrome (RNS) is a rare entity characterized by frequent relapses and persistent resistance to corticosteroids and other immunosuppressive agents for at least six months. Diuretic resistance, defined as persistent edema despite high-dose therapy, complicates management and accelerates progression to end-stage renal disease (ESRD).
To describe the clinical course of a patient with RNS secondary to primary membranous nephropathy who developed multi-drug diuretic resistance and progressed to ESRD requiring chronic hemodialysis.
A 56-year-old man with type 2 diabetes mellitus presented with generalized edema and ascites. Laboratory tests showed serum albumin 1.8 g/dL, proteinuria 13 g/24 h, and creatinine 1.2 mg/dL. Renal biopsy confirmed primary membranous nephropathy. He was treated with intravenous furosemide and spironolactone (100 mg/day), achieving initial diuresis. Immunosuppressive therapy with prednisone, mycophenolate mofetil, and cyclophosphamide was ineffective. Three months later, he relapsed with proteinuria 17 g/24 h and anasarca, receiving rituximab (1 g every 15 days), tacrolimus, and combined diuretic therapy (furosemide, spironolactone, acetazolamide, chlorthalidone, dapagliflozin) without improvement. Recurrent relapses led to progressive renal decline. In his final hospitalization, he developed an axillary abscess, hyperosmolar hyperglycemic state, and acute-on-chronic renal failure (creatinine 5.5 mg/dL), refractory to diuretics, requiring hemodialysis with no renal recovery.
RNS complicated by diuretic resistance may progress to irreversible ESRD despite intensive immunosuppression and multidrug diuretic regimens. Early recognition of treatment failure and timely initiation of renal replacement therapy are essential to improve survival and quality of life.
