Nephrotic syndrome is a common clinical syndrome among kidney diseases, with diverse etiology and pathology, different outcomes and prognosis, and individualized comprehensive diagnosis and treatment is the most critical. The disease can occur in different groups such as the elderly, children and young adults, and can be acute in onset or chronic in progression. How to individualize the treatment? The main physiological function of the kidney is to excrete metabolites from the body, which usually include water, electrolytes, creatinine, urea and other small molecules. However, if the “gate” in the kidney is broken, causing large molecules in the blood, such as albumin and globulin, to be excreted in large quantities in the urine, then it is likely to have nephrotic syndrome. Nephrotic syndrome is not an independent disease, but a class of clinical syndromes with the same characteristics in clinical manifestations, the basic features of which are large amounts of proteinuria, hypoproteinemia, or with edema, hyperlipidemia, commonly known as the three highs and one low. In severe cases, generalized edema, combined with pleural fluid and ascites, with oliguria or rapid deterioration of renal function may occur. Nephrotic syndrome can occur in different groups, such as the elderly, children, and young adults, and can be acute in onset or chronic in progression. The etiology of the disease is diverse and complex, and some patients can be clinically cured with effective treatment, while some patients can progress to uremia. Therefore, timely and scientific individualized comprehensive treatment of this disease is very critical. The causes of nephrotic syndrome are numerous, and some patients have secondary to certain extra-renal diseases, such as immune diseases, metabolic diseases, infections, allergies, tumors, drugs and genetic diseases, which are called secondary nephrotic syndrome. The secondary etiology varies in different age groups, such as diabetes and tumors in the elderly, hepatitis B and systemic lupus erythematosus in young people, and allergic purpura in children can lead to the occurrence of secondary nephrotic syndrome. While most nephrotic syndromes are caused by diseases of the kidney itself, clinically known as primary nephrotic syndrome, which can be divided into various pathological types, such as microscopic lesion nephropathy, membranous nephropathy, focal segmental glomerulosclerosis, thylakoid proliferative nephritis and membranoproliferative glomerulonephritis. Therefore, once the diagnosis of nephrotic syndrome is clarified, the first step should be to make individualized screening for common causes in different age groups to facilitate further cause-specific treatment. For example, after lupus nephritis is clearly identified, immunosuppressive drugs can be given in time to control systemic and renal immune activities; after hepatitis B-associated nephritis is clearly identified, anti-hepatitis B virus treatment can be tried in time. In addition, the treatment plan, treatment response and prognosis of nephrotic syndrome vary greatly among different pathological types; therefore, the pathological diagnosis of renal puncture biopsy becomes particularly important in the diagnostic process of nephrotic syndrome. It is generally believed that unless the patient has conditions that make renal puncture inappropriate, adult nephrotic syndrome, complex or refractory pediatric nephrotic syndrome should undergo renal puncture biopsy as soon as possible to clarify the pathological diagnosis in order to develop an individualized treatment plan and avoid blind treatment of patients, which may bring about unnecessary adverse reactions and delay the disease. Since most nephrotic syndromes are caused by immune inflammation, immunosuppressive therapy is often essential to control the disease, and hormone is still the most basic immunosuppressive drug for most nephrotic syndromes. In clinical practice, longer courses and larger doses of hormones may bring numerous side effects, and some patients with nephrotic syndrome are difficult to treat because of ineffective hormone therapy, recurrent relapses or intolerance to treatment. Domestic and foreign nephrologists usually choose traditional immunosuppressive drugs such as cyclophosphamide and cyclosporine, or try new immunosuppressive drugs such as morte-macrolide and tacrolimus. These immunosuppressive drugs have both advantages and certain side effects. Therefore, after the etiology and pathology are clearly diagnosed, we strive to develop an individualized treatment plan with high efficiency and low toxicity for nephrotic syndrome with different etiology, pathology and different clinical responses. For example, adequate hormone therapy is preferred for microscopic nephropathy; hormone alone is often ineffective for membranous nephropathy manifesting as persistent massive proteinuria, requiring hormone combined with other immunosuppressive drug regimens; and for elderly and frail patients with nephrotic syndrome, a less immunosuppressive regimen should be used as appropriate. Patients with primary nephrotic syndrome combined with diabetes mellitus should avoid high-dose hormone regimens; patients with primary nephrotic syndrome combined with hepatitis B should avoid high-dose hormones and drugs that affect liver function. Prevention and treatment of complications and drug side effects is the guarantee Nephrotic syndrome is an acute disease with a long course and complex condition. While a large amount of urine protein is excreted, anticoagulation factors and immune factors are also lost, and continuous hypoproteinemia leads to insufficient effective blood volume. Therefore, patients with nephrotic syndrome are prone to complications such as infection, hyperlipidemia, hypercoagulable thrombus and acute renal failure. Patients with nephrotic syndrome are also prone to adverse drug reactions due to a longer course of hormone therapy or the use of hormones or a combination of immunosuppressive drugs due to recurrent disease, which can be disabling or fatal in severe cases. Therefore, while the main goal of nephrotic syndrome treatment is to reduce proteinuria, it should also actively prevent and control complications or comorbidities, reduce the side effects of immunosuppressive drugs and maintain lasting stability of renal function. This requires patients to cooperate closely in the process of diagnosis and treatment, to strengthen follow-up, to observe closely, and to adjust treatment measures according to changes in their conditions. In view of the characteristics of the diagnosis and treatment of nephrotic syndrome, the Nephrology Center of the First Affiliated Hospital of Zhejiang University School of Medicine, under the guidance of Professor Chen Jianghua, the leader of the discipline and deputy director of the Chinese Medical Association Nephrology Branch, has established a specialized nephrotic syndrome group and opened a specialized nephrotic syndrome clinic to establish scientific and reasonable individualized treatment procedures and norms for various nephrotic syndromes, so as to provide reasonable individualized treatment for patients with nephrotic syndromes. We have established scientific and reasonable individualized treatment procedures and norms for various nephrotic syndromes, providing reasonable individualized treatment plans for patients with nephrotic syndromes, improving clinical efficacy and reducing complications and side effects of drugs.