Treatment:

The goals of treatment are to relieve symptoms, prevent complications and delay progressive kidney damage. Treatment of the disorder that causes the condition is necessary to control nephrotic syndrome. Treatment may be needed for life.

Controlling blood pressure is the most important measure to delay kidney damage. The goal is to keep blood pressure at or below 130/80 mmHg. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used in this case. ACE inhibitors may also help decrease the amount of protein loss in the urine.

Corticosteroids and other drugs that suppress or quiet the immune system may be used.

High cholesterol and levels should be treated to reduce the risk of heart and blood vessel problems. However, a low-fat, low-cholesterol diet is usually not as helpful for people with nephrotic syndrome. Medications to reduce cholesterol and triglycerides may be needed, most commonly statins.

A low salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem.

Low protein diets may or may not be helpful. A moderate-protein diet (1 gram of protein per kilogram of body weight per day) may be suggested.

Vitamin D may need to be replaced if nephrotic syndrome is chronic and unresponsive to therapy.

Blood thinners may be required to treat or prevent clot formation.

Expectations (prognosis):

The outcome varies; the syndrome may be acute and short-term or chronic and unresponsive to therapy. The cause and development of complications also affects the outcome.

Complications:

• Atherosclerosis and related heart diseases
• Renal vein thrombosis
• Acute kidney failure
• Chronic kidney disease
• Infections, including pneumococcal pneumonia
• Malnutrition
• Fluid overload, congestive heart failure, pulmonary edema

Calling your health care provider:

Call your health care provider if symptoms which may indicate nephrotic syndrome occur.

Call your health care provider if nephrotic syndrome persists or if new symptoms develop, including severe headache, fever, sores on the skin, cough, discomfort with urination, or decreased urine output.

Go to the emergency room or call the local emergency number (such as 911) if convulsions occur.