What are the management of nephrotic syndrome?
Nephrotic Syndrome usually presents with the classic triad of oedema, proteinuria and hypoalbuminaemia. Show
Oedema can be non-dependant eg periorbital. Consider other causes of generalised oedema eg liver disease, congestive cardiac failure and protein losing enteropathy. Assessment of severity and complications:
Features suggesting diagnosis other than INS
ManagementInvestigationsThe diagnosis of nephrotic syndrome includes:
Urine
Blood
Treatment (for INS)1. Admit to hospital on first presentation 2. If the child is profoundly ill or appears to have sepsis treat accordingly (see Sepsis) 3. Manage oedema
5. Prophylaxis against complications
Treatment of relapsesA relapse is defined as proteinuria 3+ or 4+ for 3 consecutive days, and should prompt re-introduction of full dose prednisolone:
The total time of weaning regimen can be shortened if the child relapses infrequently (2–3 relapses in any 12-month period) and responds to treatment quickly What are the main goals of treatment management for nephrotic syndrome?OBJECTIVES OF SYMPTOMATIC TREATMENT: The goal is to maintain quality of life, prevent immediate complications (thromboembolic events, infection, drug reactions), prevent late complications related to atherosclerosis, and limit the progression of the chronic renal failure.
What is the first line treatment for nephrotic syndrome?Corticosteroids are currently used as first-line treatment. A 16 weeks full-dose steroid course (1 mg/kg/day) usually induces remission in 75% MCNS in adults.
What is the expected management for the child with nephrotic syndrome?Children diagnosed with nephrotic syndrome for the first time are normally prescribed at least a 4-week course of the steroid medicine prednisolone, followed by a smaller dose every other day for 4 more weeks. This stops protein leaking from your child's kidneys into their urine.
What are the prevention of nephrotic syndrome?You can't prevent some causes of nephrotic syndrome. But you can take action to avoid damage to your glomeruli: Manage high blood pressure and diabetes, if you have them. Be sure to get vaccines for common infections, especially if you work around people who have hepatitis or other diseases.
|