Fast Five Quiz: How Much Do You Know About Nephrotic Syndrome?

Vecihi Batuman, MD

Disclosures

July 19, 2017

Minimal-change nephropathy in adults should respond to prednisone. In lupus nephritis, prednisone with cyclophosphamide or mycophenolate mofetil should induce remission.

The diet in patients with nephrotic syndrome should provide adequate caloric intake and adequate protein (1 g/kg/d). Supplemental dietary protein has no proven value. A diet with no added salt will help to limit fluid overload. Fluid restriction per se is not needed.

In secondary nephrotic syndrome, such as that associated with diabetic nephropathy, ACE inhibitors and/or angiotensin II receptor blockers are widely used. These may reduce proteinuria by reducing the systemic blood pressure, by reducing intraglomerular pressure and also by direct action on podocytes.

Rituximab, an antibody against B cells, has proved to be an effective steroid-sparing agent in children with steroid-dependent idiopathic nephrotic syndrome. However, children dependent on both steroids and calcineurin inhibitors are less likely to achieve drug-free remission with rituximab. Rituximab may also be used in children with steroid-resistant disease.

For more on the treatment of nephrotic syndrome, read here.

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