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Nephrotic Syndrome: Treatment, Procedure, Cost and Side Effects

Last Updated: Jul 05, 2024

What is the treatment?

Nephrosis or nephrotic syndrome is a kidney disease characterized by oedema and large amounts of protein in the urine and usually increased blood cholesterol. It is associated with glomerulonephritis and swelling, especially around the eyes, feet, and hands and with various systemic diseases. When the kidneys' glomeruli are damaged, they allow 3 grams or more of protein to leak into the urine during a 24-hour period. As a result of the protein loss, the fluids start to accumulate in the body’s tissues. This causes swelling and puffiness.

Treatment of nephrotic syndrome includes addressing the underlying causes besides taking the necessary steps to reduce the symptoms like high blood pressure, oedema, high cholesterol, and the risks of infection. Treatment policies are different for children and adults. Treatment usually includes medications and changes in the diet of the patient.

The first treatment for nephrotic syndrome is called prednisolone, a steroid medicine. Vaccines are also supplied to lower the risk of diseases. Fluid retention in the tissues can be treated by reducing the amount of salt and water taken each day. Blood clots are treated with the necessary drugs that thin the blood. A high cholesterol level may be treated with dietary control (eating less fat), and in some cases with cholesterol lowering drugs. Children need to take diuretics, which is a type of medicine that helps to reduce swelling in the body (oedema).

How is the treatment done?

Prior to treatment, doctors will recommend blood and urine sample tests to evaluate the condition. Protein content in the urine can be evaluated by a dipstick that changes color when dipped in urine. Blood tests will reveal the amount of protein in blood, which in case of nephrosis, will be very low. Then, ultrasound and X-Ray of the kidneys are usually prescribed for better diagnosis. Once nephrotic syndrome has been established, doctors provide the necessary medicines to prevent it from relapsing.

Doctors may recommend a kidney biopsy. It is a procedure where tiny pieces of the kidney are removed using a needle for examination with a microscope. The biopsy may reveal the underlying disease. This helps the doctor to determine a course of treatment. If a person is diabetic, it is more likely that the disease is diabetic nephropathy. In this case, a biopsy is not necessary. Proper treatment of diabetes can reduce the degradation of health by nephrosis. Medications that lower blood pressure can also effectively slow the progression of kidney disease causing nephrotic syndrome. There are two types of blood pressure lowering medications. These are- angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). Both of these have shown effective results in slowing the progression of kidney disease. Statin medications may be given to lower the cholesterol level. Patients with nephrotic syndrome should be given the pneumococcal vaccine. This helps protect against a bacterium that commonly causes infection and weakens the body further. Blood thinning medications are usually given only to people with nephrotic syndrome who develop a blood clot.

Who is eligible for the treatment? (When is the treatment done?)

Both children and adults are eligible for the treatment of nephrosis. In case of children, the treatment usually requires a longer duration. But for adults, the treatment is cured within eight to ten months without cases of further recurrence of proteins in urine.

Who is not eligible for the treatment?

People who do not experience any severe symptoms associated with nephrotic syndrome do not require medical treatment.

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Are there any side effects?

The use of Corticosteroids for the treatment of nephrotic syndrome can cause mild side effects that fade away with time. But, a doctor should be contacted if the patient suffers any of the following. Side effects of nephrosis treatment include trouble in breathing, swelling of body parts like face, lips, tongue, or throat, problems in eyes, including blurred vision or eye pain. The person may also feel belly pain and nausea which refuse to go away, muscle cramps, changes in skin including acne and blemish. Side effects of corticosteroids also include changes in the stool color which turn bloody or blackish, sudden increase in the body weight along with frequent urges of drinking water.

What are the post-treatment guidelines?

In case of adults, relapses or recurrence of protein in urine are less common after treatment. But most children encounter at least one relapse even after full treatment. Each relapse requires a further course of steroid treatment for a shorter time.

Eating, diet and nutrition do not play any major role to prevent nephrosis. But, after the treatment, patients are advised to limit the intake of dietary sodium(salt). Fluids may be recommended to help reduce edema. Hyperlipidemia can be prevented by consuming a diet low in saturated fat and cholesterol. Nephrotic syndrome fades away with the proper use of steroids and the person starts to regain and live a normal life.

How long does it take to recover?

Nephrotic Syndrome or nephrosis is a chronic disease. It usually takes a long duration for its cure, which may vary from a few months to a few years. Most patients do well within about one year. But longer treatment may be required in certain resistant cases. Some cases may need treatment for more than five years. . Thus it is hard to predict exact timeline for its cure.

What is the price of the treatment in India?

Approximate expenditure for the treatment of nephrotic syndrome varies from Rs-500 to Rs 3000. For repeated treatments, the cost may be more.

Are the results of the treatment permanent?

The treatment is usually permanent in case of adults. After adolescence, nephrotic syndrome has lesser chances of relapse and recurrence. But in case of children, even after the best treatments, at least one relapse is obvious. During this phase, steroids are again provided but for a lesser duration as the proteins excreted are also lesser than initial. This may keep recurring for a series in case of child nephrosis. However, for a person who hasn’t suffered nephrosis for five years will not be affected by it again. So in these cases, the treatment is permanent.

What are the alternatives to the treatment?

Along with the conventional treatment of nephrotic syndrome, homeopathy treatment may also be used as an alternative. Homeopathic medicines are used in extremely small dose for a longer period of time and they are prepared through a process of potentization. This way the medicines become absolutely free from any side effects. Homeopathic treatment of nephrotic syndrome include reducing the frequency of attacks, its severity and duration and also the patient’s dependence on cortisone.

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Written ByDr. Rajeev Sarpal DNB - Urology/GenitoUrinary SurgeryUrology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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