Treatment of nephrotic syndrome will depend on the underlying cause of the syndrome. Therefore, it is important that the most likely cause is identified during the diagnostic process to allow optimal treatment decisions to be made.
The main goal of treatment is to reduce the symptoms and complications of the nephrotic syndrome. This is done with a combination or lifestyle interventions and medications targeted to specific areas linked to the condition.
Antihypertensive drugs for blood pressure
Medications for controlling blood pressure are often recommended for patients with nephrotic syndrome who have hypertension. This is useful both to reduce blood pressure and to minimize the loss of protein in the urine. Common options for antihypertensive drugs for nephrotic syndrome include:
- Angiotensin converting enzyme (ACE) inhibitors: benazepril, captopril, enalapril
- Angiotensin II receptor blockers (ARBs): losartan, valsartan
These two classes of drugs are preferable to other antihypertensive drugs because they have a direct effect on kidney function and help reduce protein excretion in the urine.
Diuretic medications, also commonly known as water pills, may be helpful in reducing the swelling of edema, which is a common symptom of nephrotic syndrome. Examples of diuretic medications that may be used to reduce edema include furosemide and spironolactone.
Statin Medications for Hypercholesterolemia
Drugs to lower cholesterol levels are sometimes recommended for patients with nephrotic syndrome who have high blood cholesterol levels. It is believed that these medications help reduce the risk of associated complications, such as a myocardial infarction, although the specific benefits for patients with nephrotic syndrome are unclear.
Examples of statin drugs that may be used for patients with nephrotic syndrome include atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin.
Anticoagulant medications for blood clot prevention
For patients with nephrotic syndrome who are at risk of blood clot formation, an anticoagulant medication may be recommended. Examples of anticoagulant drugs to reduce clotting factors include warfarin and heparin.
Medications that suppress the immune system may be beneficial for patients with nephrotic syndrome who have symptoms associated with inflammation. In particular, patients with minimal associated change disease may find immunosuppressive drugs such as corticosteroids useful for controlling inflammation.
There are some diet and lifestyle interventions that can be done by patients with nephrotic syndrome to help reduce the severity of symptoms. For example, a low salt diet is useful for limiting fluid retention in the body and thus reducing the edema associated with the nephrotic syndrome.
It is also important for patients to follow general health recommendations, including regular physical activity and a healthy diet with high intake of fresh vegetables and low intake of processed foods.
It is important that patients with nephrotic syndrome have access to adequate support during and after treatment. Many medications used to treat nephrotic syndrome, such as antihypertensives and diuretics, are used continuously and may require dose adjustments in the future.
Regular check-ups should also be performed to monitor continued health. This is particularly important for patients taking immunosuppressive drugs, which may require immunizations and monitoring for signs of toxicity. However, all patients should have regular appointments with their physician.