Nephrotic syndrome: treatment
Nephrotic syndrome is usually treated based on the underlying condition. However, since this is not always considered to be causal, therapeutic measures are usually designed to relieve symptoms:
Nephrotic syndrome is often accompanied by high blood pressure . To normalize this and reduce the significant loss of protein, doctors usually take antihypertensive drugs (such as ACE inhibitors). Lowering blood pressure is particularly important because persistent blood pressure further damages the kidneys.
The formation of swelling is characteristic of nephrotic syndrome. In general, water deposits can be removed well with dehydrating agents called diuretics. To prevent fluid from building up in the tissues, your doctor will also set a daily rate of alcohol and salt intake (no more than six grams per day). Since diuretics release not only water but also more and more electrolytes (such as sodium, potassium), your doctor will regularly check the amount of mineral salts in your blood. The drainage should not be too sudden, otherwise the body loses too much fluid in a short time. This increases the risk of blood clots.
Nephrotic syndrome is associated with an increased risk of blood clots (risk of thrombosis) . To prevent thrombosis, patients are given medicines that inhibit blood clotting (such as low molecular weight heparin). Wearing compression stockings also protects against blood clots. If you have already developed a thrombosis, your doctor will prescribe anticoagulants, usually of the class of coumarins.
In some cases, the nephrotic syndrome is called an increase in blood lipids . They can also be treated with medicines that lower cholesterol (such as ESC inhibitors). However, a diet low in fat and cholesterol does not have enough effect.
Nephrotic syndrome is often accompanied by a weakened immune system and hypersensitivity to infection . This is due to an increased loss of antibodies (immunoglobulins) in the urine. Bacterial infections can be fought with antibiotics. If a large amount of antibody is lost, the missing immunoglobulins can be at least partially replaced by fillers. However, if you lose protein, the antibodies will be lost and replaced. In some cases, vaccination can be useful to protect against certain infections, such as pneumococci or the flu (“real” flu).
Membrane glomerulopathy, one of the most common causes of nephrotic syndrome in adults, is caused by a disorder of the immune system. Drugs that suppress defense and suppress inflammatory reactions (so-called immunosuppressive) are used here.
In children, minimal change in glomerulopathy is the most common cause of nephrotic syndrome. In most cases, treatment also works well with immunosuppressive drugs such as cortisone. However, recurrence (recurrence) of half of affected children after stopping the drug. Doctors can then use other means (such as cyclosporin A).