Nephrotic Syndrome Symptoms

How to reduce proteinuria for Nephrotic Syndrome patients? For different causes, the treatment methods are a little different. In this article, lets have a quick look.

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How to Reduce Proteinuria for Nephrotic Syndrome Patients

2019-01-09 18:09

How to Reduce Proteinuria for Nephrotic Syndrome PatientsHow to reduce proteinuria for Nephrotic Syndrome patients? For different causes, the treatment methods are a little different. In this article, let’s have a quick look.

1. Minimal change disease

Kidney biopsy is usually not required. After about 15 days to 2 months’ treatment, proteinuria will turn negative. Single use of immunosuppressant can also achieve the similar effect. And the elevation of creatinine level is usually temporary. After medication, proteinuria will be reduced, and serum creatinine level will be normalized. For over 90% of patients with Minimal Change Disease, their kidney function is not affected.

However, relapse occurs frequently, so steroid reduction should be slow, and meanwhile paying attention to infection prevention. As long as the correct treatment and life are strictly followed, most patients can get well.

2. Membranous Nephropathy

-If 24h urine protein is less than 4g, ACEI or ARBs can be used to lower proteinuria and reduce blood pressure. And kidney failure usually does not occur.

-If 24h urine protein is 4-8 g, steroids and cytotoxic drugs can be used. After about 3 months’ treatment, proteinuria will be reduced.

-If 24h urine protein persists over 8g, besides treatment, complications should be prevented, such as renal venous thrombosis, interstitial nephritis caused by diuretics or other drugs.

3. Mesangial proliferative nephropathy

-If 24h urine protein is less than 0.5 g, no special drugs are needed, but you can take Chinese medicine into consideration and have regular review.

-If 24h urine protein is over 0.5g, ACEI or ARBs can be used, but the dosage should be high enough to take effect.

-If 24h urine protein is greater than 2.5g, besides ACEI and ARBs, steroids and immunosuppressants can be used.

It should be noted that although the urinary protein of mesangial proliferative nephropathy is generally not very much, it is not easy to be reduced. Patients with 1-2 grams of urinary protein should be cautious with or without steroids and immunosuppressive agents, because those drugs may cause a lot of side effects. It is suggested to use Chinese medicine or the combination of Chinese medicine and western medicine to lower proteinuria.

4. Focal Segmental Glomerulosclerosis (FSGS)

In 60% of patients, urinary protein is controlled with steroids and immunosuppressants. Prednisone + cyclophosphamide is preferred, and cyclophosphamide can be replaced with cyclosporine or tacrolimus. And the effect is usually taken slowly. After 3 months’ treatment, you can assess the effectiveness.

Patients with poor prognosis can be treated with rituximab or plasmapheresis to improve the prognosis.

In traditional Chinese medicine, glomerulosclerosis belongs to phlegm turbidity and stagnation, which requires traditional Chinese medicine treatment of activating blood circulation, clearing collaterals and removing blood stasis so as to further reduce urinary protein and prevent recurrence.

5. Membranoproliferative nephropathy

Hormones and immunosuppressants are not recommended for asymptomatic patients with urinary protein less than 3.5 g/24 h, as they are ineffective in more than 90% of patients and can accelerate the progression of kidney disease. ACEI or ARBs can be used.

Patients with urinary protein greater than 3.5 g /24 h may consider using steroids for 4 months.

If the urine protein does not drop after 4 months, stop the drug; If there is a significant decrease in urinary protein, maintenance therapy with the minimum effective dose is recommended.

In addition to the ACEI/ARB drugs can alleviate the disease, combination of Chinese medicine treatment and western medicine can reduce by about 70% of the urine protein.

Like FSGS with poor prognosis, patients with membranous proliferative nephropathy can also be treated with either rituximab or plasmapheresis.

Which kind of kidney disease causes your Nephrotic Syndrome? You can find the corresponding measures to lower your proteinuria. For more information on Nephrotic Syndrome treatment, please leave a message below or contact online doctor.

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