The treatment of refractory nephrotic syndrome is divided into the following points: 1. First of all, in the nephrology department, great emphasis is placed on renal puncture biopsy, so for most patients with refractory nephrotic syndrome, as long as conditions allow, it is emphasized that renal puncture biopsy must be done first to clarify the type of pathology, because the type of pathology is different treatment methods; for example, in membranous nephropathy, hormones plus immunosuppressants are required, while microscopic lesions with hormones alone can achieve better results. For example, in membranous nephropathy, hormones and immunosuppressive agents are needed, while hormones alone can achieve better results in microscopic lesions, so renal puncture biopsy must be done; 2. For refractory nephrotic syndrome, try to find the cause as much as possible to see if he has lupus leading to nephrotic syndrome, or if it is secondary to diabetes; if secondary factors can be found, the treatment of its primary cause is also helpful to the treatment of nephrotic syndrome; 3. But still unclear, then it is called primary nephrotic syndrome, in this case if in refractory nephrotic syndrome, we should fully consider whether the previous treatment of nephrotic syndrome is standardized, especially whether the use of hormonal methods is standardized. If the standard and the effect is not good, consider adding other immunosuppressants on top of hormone therapy, such as cyclosporine, tacrolimus or cyclobenzaprine, which are newer immunosuppressants, and this is also a more clinically used treatment method.