Treatment Overview

Treatment for nephrotic syndrome depends on the cause and the age of the person who has the condition. Medicines, changes in diet, and care for other conditions, such as diabetes or high blood pressure, are all possible treatments for this syndrome. These treatments may reverse, slow, or prevent further kidney damage.

Most children who have nephrotic syndrome do well with treatment and have a normal life expectancy.

Doctors define complete recovery as living without symptoms or treatment for more than 2 years.

Initial treatment

Treatment of nephrotic syndrome depends on the cause of the disease and may include:

• Corticosteroids, such as prednisone or prednisolone, to reduce swelling.
• Diuretics to reduce fluid buildup in the body (edema) and to help with reducing sodium, potassium, and water. Fluid reduction should occur slowly to avoid further kidney damage and low blood pressure.
• Medicines, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), to reduce the amount of protein lost in the urine, lower blood pressure, and slow the progress of the disease.
• In rare cases, salt-free albumin given through a vein (IV). Albumin helps remove extra fluid from the tissues.

First treatments can last from 6 to 15 weeks, often longer in adults. Depending on how severe your symptoms are or whether they return, ongoing treatment may be needed for months to years, or even for the rest of your life.

Ongoing treatment

Ongoing treatment for nephrotic syndrome and complications of the disease include:

• Daily or alternate-day prednisone, if nephrotic syndrome returns.
• Cyclophosphamide, cyclosporine, or mycophenolate mofetil, when treatment with corticosteroids is not successful.
• Steps to lower blood pressure, including medicine, a healthier diet, and exercise. Untreated high blood pressure increases your risk for stroke or heart attack. For more information, see the topics High Blood Pressure, Coronary Artery Disease, and Stroke.
• Changes in diet to replace nutrients lost through the urine, reduce fluid buildup in the body, and reduce the risk of complications. Some doctors prescribe a diet that limits protein, salt (sodium), and fats but is high in carbohydrates. The amount of protein allowed may vary, depending on your condition.
• Anticoagulants, such as warfarin (Coumadin) or heparin, to treat blood clots if they form.
• Early treatment of infections with antibiotics.
• Vaccinations with a pneumococcal vaccine(What is a PDF document?), chickenpox (varicella) vaccine, and a yearly flu shot. Vaccination is not recommended until nephrotic syndrome has responded to treatment with corticosteroids.
• Calcium and vitamin D supplements to protect your bones and help prevent osteoporosis during long-term corticosteroid treatment (for example, prednisone).

You may need emotional support during treatment for nephrotic syndrome. If you or your child has nephrotic syndrome and you are having a hard time handling treatment or the severity of your child's condition, it may help to talk with a doctor or seek counseling.

Treatment if the condition gets worse

Sometimes treatment for nephrotic syndrome is unsuccessful. If this occurs, you may develop chronic kidney disease. Your doctor may recommend that you begin hemodialysis, peritoneal dialysis, or consider a kidney transplant. For more information, see the topic Chronic Kidney Disease.

Clinical trials are ongoing to test more effective medicines for the treatment of steroid-resistant (relapsing) nephrotic syndrome. If treatment has not successfully controlled your nephrotic syndrome, ask your doctor about clinical trials. To take part in a clinical trial, you may need to travel to a large treatment center.