Treatment of nephrotic syndrome: medications, diet

The treatment regimen depends on what disease or condition caused the development of nephrotic pathology. Usually, the main treatment is used in combination with the etiological treatment (aimed at neutralizing the underlying cause).

The main groups of drugs used are the following:

• glucocorticosteroid hormones;
• immunosuppressants;
• diuretics;
• cytostatic agents;
• infusion solutions;
• antibiotics.

Clinical guidelines for non-drug treatment:

• in the absence of contraindications, physical activity should not be limited;
• It is extremely important to follow a diet that maintains a physiological level of protein food consumption, with salt restrictions (if there is edema and high blood pressure).

Medicines for nephrotic syndrome

Let us consider in more detail each group of drugs used for nephrotic syndrome.

• Hormonal drugs of steroid origin have anti-inflammatory, anti-edematous, anti-shock, anti-allergic and immunosuppressive properties. Most often, the drugs of choice are Prednisolone, Prednisone, Triamcinolone, which stop the inflammatory process, normalize capillary patency, and inhibit the function of neutrophils. Corticosteroids can be used, including in nephrotic syndrome of autoimmune etiology.

1. Prednisolone is prescribed orally, for adult patients - 60-80 mg/day, for children - 1-2 mg/kg/day. The specified amount of the drug is divided into 2-4 doses, daily at the same time.
2. Prednisone is prescribed in an amount of 0.1-0.5 mg/kg/day.
3. Triamcinolone is taken orally, for adult patients at 12-48 mg/day, for children – at 0.416-1.7 mg/kg/day.

The duration of therapy may vary from one and a half to five months. Side effects during treatment may include insomnia or drowsiness, increased appetite and weight, dystrophic changes in muscles, deterioration of skin condition, etc.

• Cytostatic drugs can be prescribed in combination with hormonal treatment or without it. Their main purpose is to inhibit cell division. Why is their use appropriate for nephrotic syndrome?

1. Cytostatics are used when the patient’s body is not susceptible to hormonal drugs, or when there are contraindications to their use.
2. Cytostatics are prescribed against the background of hormonal treatment in pediatrics, as well as in cases where such treatment has proven ineffective.

For patients with nephrotic pathology, the following drugs and dosages are recommended:

1. Cyclophosphamide in the amount of 2-3 mg/kg/day, for 2-3 months;
2. Chlorambucil in the amount of 0.15-0.2 mg/kg/day, for 2-2.5 months.

• Immunosuppressants are prescribed to suppress the immune response if nephrotic syndrome develops against the background of autoimmune pathologies. Such pathologies are characterized by the release of special antigens that are attacked by antibodies of immune cells. Taking immunosuppressants leads to the suppression of the mechanism of antibody production.

Patients with nephrotic syndrome are prescribed:

1. Cyclosporine orally in an amount of 2.5-5 mg/kg/day;
2. Azathioprine orally 1.5 mg/kg/day.

• Diuretics are used to eliminate excess fluid accumulation in tissues. The use of diuretics in nephrotic syndrome, leg edema is due to increased fluid excretion from the body by reducing the reabsorption of salts and water in the kidneys, blocking the reabsorption of sodium.

1. Furosemide is taken in the morning, before meals, 20-40 mg;
2. Spironolactone is taken orally at 25-100 mg/day;
3. Indapamide is taken orally at 2.5 mg once a day.

• Infusion drugs are administered to the patient's body to stabilize blood circulation and metabolism, to eliminate signs of dehydration and intoxication. Patients with nephrotic syndrome may be administered the following drugs:

1. Albumin 20%, 200-300 ml per day;
2. Plasma – 500-800 ml per day;
3. Rheopolyglucin – by drip in a volume of 500 ml per day.

• Antibiotics are prescribed if nephrotic syndrome has developed against the background of chronic glomerulonephritis, with an increased likelihood of an infectious process.

1. Penicillin drugs (Ampicillin 0.5 g up to six times a day).
2. Cephalosporin drugs (Cefazolin 1-4 g/day, in 2-3 doses).
3. Tetracycline drugs (Doxycycline 0.1-0.2 g 1-2 times a day).

• To prevent increased thrombus formation, patients with nephrotic syndrome should be prescribed small amounts of anticoagulants (for example, Fraxiparine in combination with acetylsalicylic acid).

Vitamins for nephrotic syndrome

Treatment of the disease necessarily includes taking medications. But in addition to the basic treatment, it is necessary to take vitamins that will support and improve kidney function.

Our body needs a variety of vitamins and minerals every day. To improve kidney function, many of these substances are also required, but we will tell you which ones you should pay special attention to:

• Vitamin A takes part in many important reactions: for example, a lack of retinol can become one of the factors in the development of pyelonephritis, the formation of microliths in the kidneys. In addition, retinol strengthens cell membranes in the kidneys, improves metabolic processes: this vitamin can be obtained by eating pumpkin, carrots, nuts.
• Vitamin E helps remove salts deposited in the kidneys, has a diuretic effect, and cleanses the urinary tract. Tocopherol is present in wheat sprouts, unrefined vegetable oils, corn, beans, and sea fish.
• Vitamin B ₁ is involved in fat and protein metabolism, facilitates kidney function. Thiamine is present in unrefined rice, bran, corn.
• Vitamin B ₂ ensures the functioning of the glandular systems in the body, improves the condition of blood vessels, including renal ones. Riboflavin is present in milk and eggs, as well as in plant foods (peaches, carrots, spinach, beets, tomatoes, wheat grains).
• Vitamin B ₃ is involved in cellular energy metabolism processes, optimizes the protective abilities of the kidneys, and prevents the destruction of liver cells. Niacin can be obtained by eating cereals and most plant products.
• Vitamin B ₆ takes part in the synthesis of transaminase, improves the absorption of proteins, prevents the formation of stones in the liver and kidneys. Pyridoxine is found in oatmeal and buckwheat, nuts, bananas, berries.
• Vitamin B ₁₂ improves processes affecting the nervous system, regulates hematopoiesis, prevents kidney pain. Cyanocobalamin is present mainly in animal products - meat, liver, eggs.
• Vitamin C can strengthen vascular walls, optimize blood clotting, and prevent the development of inflammatory processes. Ascorbic acid is present in sufficient quantities in currants, citrus fruits, cabbage, kiwi, rose hips, and tomatoes.

If you prefer to get the necessary vitamins not from food, but by taking them as part of complex preparations and supplements, it is very important to prevent the development of hypervitaminosis. Excess of even the most important vitamins negatively affects the function of many organs, including the kidneys. Given this, you should not take several equivalent vitamin preparations at once. Carefully study the composition of the dietary supplement and take it according to the instructions and recommendations of your doctor.

Physiotherapy treatment

Patients with nephrotic lesions may be recommended:

• consumption of mineral waters;
• sodium chloride baths, carbon dioxide baths;
• amplipulse therapy (treatment with sinusoidal modulated currents);
• Microwave therapy (microwave therapy, involves the use of an ultra-high frequency electromagnetic field);
• ultrasound therapy (use of ultrasonic vibrations);
• UHF therapy (treatment with a large high-frequency electromagnetic field);
• direct current therapy.

Drinking mineral water and taking mineral baths are considered the most common procedures for nephrotic syndrome. If the patient has undergone surgery for pyelonephritis or urinary tract stone formation, physiotherapy may be prescribed no earlier than 10 days after the surgery. This depends on the specifics of postoperative recovery.

Physiotherapy procedures are contraindicated:

• during the period of active inflammatory process;
• in the terminal phase of chronic pyelonephritis;
• with polycystic kidney disease;
• in case of hydronephrosis in the decompensation stage.

Folk remedies for nephrotic syndrome

To avoid unwanted side effects, many people turn to folk medicine. Indeed, folk methods are successfully used to treat many diseases. However, in the case of nephrotic syndrome, everything is not so rosy: this pathology is very serious, and it cannot be solved by using folk remedies alone. Such treatment is appropriate only at the stage of recovery of the body, after or against the background of drug therapy prescribed by a doctor.

Natural herbal preparations have anti-inflammatory, diuretic, anti-allergic properties, they deliver essential substances to the body of a sick person, including vitamins and minerals. We suggest you familiarize yourself with several popular recipes that can be used in the recovery period of nephrotic syndrome.

• Take 100 g of crushed walnuts and dried figs, mix with 250 g of honey and three lemons minced (with the peel). Use the mixture 1 tbsp. three times a day, 15 minutes before meals. The course of treatment can last a long time, until a stable improvement in the condition.
• Take 1 tbsp. corn silk, the same amount of cherry tails, pour 0.5 l of boiling water. Infuse until cool, filter. Take 100 ml 4 times a day until symptoms are steadily reduced. There is no need to prepare the medicine for future use: it is better to prepare a fresh infusion daily.
• Mix 2 teaspoons of birch leaves, 1 teaspoon of strawberry leaves, 3 teaspoons of flax. Pour 750 ml of boiling water over the mixture, leave for 40 minutes, filter. Take 100 ml 4 times a day before meals.
• Black chokeberry berries normalize the condition of patients with nephrotic syndrome: they should be eaten 10 pieces per day.
• To stabilize your health, drink an infusion of hawthorn berries (1 tbsp. berries per 300 ml of boiling water). Take the infusion before meals, 50-100 ml.

The listed recipes will be able to eliminate the basic signs of the disease, as they promote the removal of excess fluid, normalize salt metabolism, and lower cholesterol levels.

Herbal treatment

The use of herbs is a great way to restore kidney function and alleviate many symptoms of the disease. But do not forget that even multi-component herbal preparations can only be considered as auxiliary therapeutic agents.

• Take 10 g of strawberry, birch and nettle leaves, and 50 g of flax seeds. Brew in 0.5 l of boiling water. After cooling, filter and take a little during the day (between meals).
• Prepare the following mixture: 3 tablespoons of orthosiphon stamineus, 3 tablespoons of plantain, the same amount of celandine and rose hips, 2 tablespoons each of field horsetail and yarrow, 4 tablespoons of calendula flowers. Brew the plants in 1 liter of boiling water. Take 50 ml before each meal.
• Prepare a mixture of 1 teaspoon of currant leaves, the same amount of betony and chamomile. Pour 250 ml of boiling water, leave for half an hour. Take 50 ml 4-5 times a day.

For kidney diseases, cucumber or pumpkin juices are considered very useful. Such juice can be drunk on an empty stomach, 1-2 tbsp. three times a day (but not more than 100 ml per day).

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ]

Homeopathy for Nephrotic Syndrome

Homeopathic treatment at the recovery stage can be as follows:

• For edema – Barita carbonica 6, Aurum metallicum 6, Lachesis 6
• For drowsiness, headaches, nausea - Ammonium album 6
• For anemia – Ferrum metallicum 12
• For convulsive muscle contractions, damage to the nervous system - Cuprum metallicum 12, Ammonium album.

In some cases, the use of the immunostimulant Echinacea 3 is justified to speed up recovery.

Homeopathic remedies do not have side effects (allergies can be detected extremely rarely, but many homeopaths consider such cases to be isolated). Treatment can be carried out at any age, but there is no standard dosage: it is selected by the doctor taking into account the constitutional and other characteristics of the patient. Usually, such prescriptions require a personal meeting between the homeopathic doctor and the patient.

Surgical treatment

Surgery is rarely required to treat patients with NS. Only in isolated cases, if acute signs of renal failure are increasing, may a doctor prescribe surgery to correct and replace the blood vessels in the kidneys.

In most situations, drug treatment is sufficient for the patient to recover.

The need for surgery may arise when complications develop that pose a threat to the normal function of the kidneys and the body as a whole. If the condition of the kidney is critical, doctors may consider the possibility of performing an organ transplant.

Nutrition and diet for nephrotic syndrome

Patients are usually prescribed diet table No. 7: such a diet will help to stabilize metabolic processes more quickly, regulate the daily volume of urine, and prevent repeated accumulation of fluid in the tissues.

The diet can be more or less strict, depending on whether there is swelling, what the level of protein is in the urine, whether there are changes in blood pressure, etc.

The essence of the change in nutrition is as follows:

• the daily diet should be within the range of 2750-3150 kcal;
• food is taken frequently, but in small amounts (optimally 6 times a day);
• frying of products is excluded;
• the amount of salt is limited to 2 g/day;
• protein is included in the diet (in the amount of 1.5 g per kg of weight);
• fluid intake is limited (until the swelling disappears);
• foods rich in potassium are included in the diet (as a result of treatment with diuretics);
• consumption of animal fat is limited (up to 80 g/day);
• carbohydrate consumption increases (up to 450 g/day).

The following foods are prohibited: baked goods (if they contain salt or soda), fatty meat and fish, fatty dairy products, cheeses, butter and margarine, beans, pickled and salted foods, chocolate and sweets, spices, soda, coffee.

Recommended for use:

• baking without salt and soda;
• low-fat dairy products;
• vegetable oils;
• cereals, vermicelli;
• raw or boiled vegetables, fruits, berries, greens;
• berry, herbal teas, compotes, jelly.

Oats for nephrotic syndrome and leg edema

Oats perfectly cleanse the kidneys and are a strong diuretic. Therefore, its use in nephrotic syndrome is more than justified.

There are many recipes for making folk remedies from oats. But it should be noted that even ordinary oatmeal without salt and sugar will help the kidneys recover faster. If oatmeal does not suit you for some reason, you can recover by listening to the following recipes.

• Oat milk.

200 ml of milk are poured into a saucepan, brought to a boil, 1 tbsp of oats are added, cooked until done, and filtered. The first few days, take 100 ml per day, then gradually increase the volume and bring it to 1 liter. After that, reduce the volume again, bringing it to the original 100 ml. This cycle is repeated 3-4 times.

• Oatmeal broth.

Take one glass of unpeeled oats, pour 1 liter of water and put on the fire. Cook for one and a half hours at a low boil. As the water boils away, add fresh water. Then cool the broth, filter and put in the refrigerator. Drink the heated broth 100 ml three times a day between meals.

• Oatmeal infusion.

Rinse half a glass of unpeeled oats, pour into a thermos, add 0.5 liters of boiling water. Close the thermos with a lid for 12 hours (preferably overnight). In the morning, beat the resulting mass with a blender and, without adding anything else, eat instead of breakfast. A similar procedure is repeated:

• during the first month – once a week;
• during the second month – twice a week;
• during the third month – again once a week.

A similar recipe can also be used to prevent relapses of nephrotic syndrome.

Nephrotic Syndrome and Flu Vaccines

It is generally accepted that immunoprophylactic measures using active and inactivated vaccines are possible only with confirmed full recovery based on the absence of clinical signs of the disease and laboratory test results. The issue of vaccinations can be considered no earlier than a month after the completion of the therapeutic course. Experts believe that this period may be sufficient for the body to adequately perceive the vaccine.

Vaccination of children who have had nephrotic syndrome should be carefully considered by a pediatrician.

Patients whose pathology was caused by glomerulonephritis are shown annual administrations of a trivalent influenza vaccine, due to the severe course of the infection with a high probability of developing neurological and respiratory disorders.

Immunization of pediatric patients is carried out with a split vaccine, which contains hemagglutinins of three current strains of the influenza virus (as recommended by the World Health Organization for the current epidemiological season).

In children with a low level of immune protection, it is recommended to administer two doses with an interval of 14 days.

Vaccination with anti-influenza serums is not carried out during periods of exacerbation of the disease, as well as in cases of frequent relapses (with a frequency of once every one and a half years or more often).