With the continuous progress of medical research, the treatment of nephropathy has been gradually improved. Refractory nephrotic syndrome refers to nephrotic syndrome in which the disease is not relieved after more than 8 to 12 weeks of adequate hormone treatment, or is prone to recurrence after hormone reduction despite treating patients. Refractory nephrotic syndrome generally includes the following conditions: (1) glucocorticoid dependence, which refers to the application of glucocorticoid therapy, urine protein can be significantly reduced or even turned negative, but in the process of reducing the dose (not yet reached the maintenance dose) nephrotic syndrome and recurrence, and then increase the dose of glucocorticoid is still effective; (2) glucocorticoid resistance, which refers to a full dose of glucocorticoid (lmg prednisone per kg of body weight per day in adults (3) Glucocorticoid intolerance refers to patients with nephrotic syndrome who cannot tolerate the adverse effects of hormones due to active peptic ulcer, active tuberculosis, active hepatitis, diabetic nephropathy, etc.; (4) Recurrent relapse refers to patients with nephrotic syndrome who have relapsed more than 2 times within 6 months or more than 3 times within 1 year after remission by treatment. Refractory nephrotic syndrome accounts for about 1/3 of all patients with nephrotic syndrome. The treatment of these patients usually requires the combined use of glucocorticoids and immunosuppressants and timely management of complications such as infection, embolism and acute renal insufficiency. So how should refractory nephropathy be treated? First of all, it should be clear whether refractory nephropathy is true or false refractory. True refractory is the patient’s pathological type is not sensitive to treatment, such as membranous nephropathy, C1q nephropathy, membranoproliferative glomerulonephritis, focal segmental glomerulosclerosis, etc. Pseudo-refractory means that the nephrotic syndrome becomes sensitive to hormones or remits on its own after the removal of some causative factors. For true refractory nephropathy, corresponding measures can be taken according to different situations, and many patients can still get good results. Clinical experience shows that for cases that do not remit with hormones alone or are prone to relapse after hormone reduction, other immunosuppressive drugs, such as cyclophosphamide, azathioprine, mycophenolate sodium, cyclophilin, tacrolimus, etc., can be added after 2-4 weeks of hormone use, but of course the above drugs must be under the guidance of an experienced specialist. Studies have shown that the combined use of immunosuppressive drugs can increase the remission rate. In addition, during the application of immunosuppressive therapy, patients should pay attention to rest, prevent colds, pay attention to warmth, and enhance the body’s resistance, as often infection and exertion are also important triggers for disease relapse. It should be said that the vast majority of patients with refractory nephrotic syndrome can recover after careful treatment by doctors.