Nephrotic Syndrome

​General treatment of the symptoms of nephrotic syndrome

• Diuretics to help get rid of excess water and salt
• Dietary salt restriction
• Medications such as ACE inhibitors or angiotension receptor blockers (ARB) to lower blood pressure, prevent worsening of kidney disease, and reduce the amount of protein excreted in the urine.
• Anticoagulation therapy (Blood thinners) to prevent blood clots if the protein leak is significant.

Acute Treatment

• Immunosuppressant: medication that alter the body’s immune system to reduce the damage to the kidney cells. These medications often have side effects.
  
• Renal replacement therapy in the form of dialysis may be required if the kidney function is severely impaired.

Treating the underlying disease

• Minimal change disease (MCD) almost always responds initially to treatment with
  glucocorticoids (steroids). However, relapses are common, and additional treatment
  with other immunosuppressants may be required to maintain remission.

• Focal segmental glomerulosclerosis (FSGS) can be classified as primary FSGS or
  Secondary FSGS The treatment of primary FSGS is similar to MCD Secondary FSGS is
  treated primarily with ACE inhibitors or ARBs.
  
• Membranous nephropathy (MN) for patients with mild symptoms, a period of
  “watch and wait” is recommended initially to determine if the condition is worsening
  or causing complications Immunosuppressive treatment is generally held off for a
  period of about 6 months until/unless symptoms worsen However if the patient has
  severe symptoms from the start or if the condition progresses while under monitoring,
  treatment should be started.
  
• Diabetes mellitus  - Management includes intensive management of blood sugar
  levels, cholesterol, and blood pressure.
  
• Lupus -Patients with lupus who have nephrotic syndrome or evidence of worsening
  kidney function can be treated with steroids and immunosuppressants.