Do you take steroids for nephrotic syndrome?

Written by Hu Lin
Nephrology
Updated on March 31, 2025
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Once nephrotic syndrome is diagnosed, corticosteroid therapy becomes a primary treatment, and the commonly used steroid is prednisone. If there is liver damage or the treatment effect of prednisone is not good, oral prednisolone or intravenous methylprednisolone can be used. Due to its long half-life and severe side effects, dexamethasone is now generally less used. The course of treatment with corticosteroids for nephrotic syndrome is relatively long, needing about one to one and a half years. During this process, the use of steroids has three phases: the initial full-dose phase, during which a relatively large dose of the hormone is used for about two to three months; the second phase is a slow reduction process; the third phase is a low-dose maintenance process. Overall, during the use of steroids, patients must regularly follow up at outpatient clinics, and adjust the steroids according to the doctor's advice. One must not arbitrarily reduce the dose or stop the medication, as this can easily lead to a relapse of nephrotic syndrome.

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Written by Zhou Qi
Nephrology
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How long will it take for nephrotic syndrome to get better?

Most cases of nephrotic syndrome are primary nephrotic syndrome, which refers to the absence of specific causes and may be related to immune dysfunction. The disordered immune system attacks the glomerular capillaries causing damage to the filtration barrier, resulting in the patient excreting large amounts of urinary protein. For primary nephrotic syndrome, treatment generally involves the use of corticosteroids or a combination of hormones and immunosuppressants. About 50-60% of patients respond effectively to the medication, which typically takes about two months to take effect. Patients who respond quickly might see effects within one to two weeks, while those with less sensitivity to the medication may need three to four months. The general course of medication is about one year.

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Written by Zhou Qi
Nephrology
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Causes of vomiting in nephrotic syndrome

Patients with nephrotic syndrome may experience vomiting for several possible reasons. First, nephrotic syndrome causes severe edema in patients, including edema of the gastrointestinal tract. This state of edema may lead to reduced gastrointestinal motility and symptoms of nausea and vomiting. Furthermore, patients with nephrotic syndrome have low plasma protein levels and poor immune function, making them prone to infections. If there is an infection in the gastrointestinal tract, patients may exhibit clinical symptoms of vomiting as well as potentially experiencing diarrhea, abdominal pain, and so on. Additionally, some patients experience vomiting due to the side effects of medications used during the treatment of nephrotic syndrome.

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Written by Wu Ji
Nephrology
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What is nephrotic syndrome?

Nephrotic syndrome is a common manifestation of glomerular disease, caused by a variety of etiologies, with large differences in treatment response and prognosis. The pathological causes of nephrotic syndrome are diverse, with the most common types being minimal change disease, focal segmental glomerulosclerosis, mesangial proliferative nephritis, membranous nephropathy, and membranoproliferative glomerulonephritis. Nephrotic syndrome can be classified into primary and secondary types based on its cause. The diagnosis of primary nephrotic syndrome mainly depends on the exclusion of secondary nephrotic syndrome. Common causes of secondary nephrotic syndrome include diabetic nephropathy, lupus nephritis, renal amyloidosis, drug-induced nephropathy, and renal tumors.

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Written by Zhou Qi
Nephrology
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Is nephrotic syndrome easy to treat in children?

The diagnostic criteria for nephrotic syndrome are a 24-hour urinary protein quantification exceeding 3.5g and plasma albumin levels below 30g/l. This is due to severe damage to the glomerular capillary network, which has many pathological types since there are various components to the glomerular capillaries, and damage to different components is referred to as different pathological types. Among children, the most common pathological types are minimal change disease and mesangial proliferative glomerulonephritis. These two types are relatively easier to treat. Most children are sensitive to steroid medication. However, treatment becomes difficult with other pathological types, such as focal segmental glomerulosclerosis, which shows less sensitivity to steroids. (Medication use should be under the guidance of a doctor.)

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Written by Zhou Qi
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Does nephrotic syndrome cause itchy skin?

Nephrotic syndrome generally does not cause itchy skin in patients. In patients with nephrotic syndrome, the glomerular filtration barrier is severely damaged, leading to a significant presence of urinary protein and edema, but itchy skin is a rare clinical symptom. If a patient experiences itchy skin, it is recommended to visit the dermatology department of a standard hospital. As such patients may have a disordered immune system, they are prone to various skin issues, such as allergic dermatitis and eczema, which might cause symptoms of itchy skin. However, these are not directly related to nephrotic syndrome.