<![CDATA[Relapse in adult nephrotic syndrome represents a clinically complex phase characterized not only by recurrent proteinuria but also by heightened vulnerability to metabolic and infectious complications. A 24-year-old male with a prior history of nephrotic syndrome presented with generalized edema, foamy urine, and dysuria. Urinalysis showed 3+ proteinuria, while laboratory evaluation revealed severe hypoalbuminemia (1.1 g/dL) and hypokalemia (2.9 mmol/L) with bacteriuria. A diagnosis of relapsing nephrotic syndrome complicated by moderate hypokalemia and urinary tract infection was established. The patient received step-down intravenous methylprednisolone, ceftriaxone, 20% albumin infusion, combined furosemide–spironolactone therapy, and cautious intravenous potassium replacement under continuous ECG monitoring. Within seven days, edema improved significantly and serum potassium normalized without complications. Infection-triggered relapse may worsen electrolyte imbalance through urinary losses and diuretic therapy. Early identification of hypokalemia and infection is essential to prevent cardiac and renal complications. Coordinated pharmacologic management allows safe correction while maintaining fluid balance. Prompt recognition and multidisciplinary management of relapse-associated infection and electrolyte disturbance are critical to improving outcomes in adult nephrotic syndrome.]]>
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