Treatment of nephrotic syndrome: drugs, diet

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

The main groups of drugs used are:

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

Clinical recommendations for non-drug treatment:

• in the absence of contraindications, motor activity should not be restricted;
• it is extremely important to maintain a diet with the support of a physiological level of consumption of protein foods, with the restriction of salt (with available swelling and high blood pressure).

Medicines for nephrotic syndrome

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

• Hormonal preparations 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 the patency of the capillaries, oppress the function of neutrophils. Corticosteroids can be used, including, and with a nephrotic syndrome of autoimmune etiology.

1. Prednisolone is administered orally, for adult patients - 60-80 mg / day, for children - 1-2 mg / kg / day. This amount of the drug is divided into 2-4 admission, every day 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 adults, 12-48 mg / day, for children - 0.416-1.7 mg / kg / day.

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

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

1. Cytotoxic drugs are used in the absence of susceptibility of the patient's organism to hormonal preparations, in the presence of contraindications to their reception.
2. Cytotoxic drugs are prescribed on the background of hormonal treatment in pediatrics, as well as in cases when such treatment proved to be unsuccessful.

Patients with nephrotic pathology are recommended such drugs and dosages:

1. Cyclophosphamide in an 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.

• Immunosuppressors are prescribed to suppress the immune response if the nephrotic syndrome develops against the background of autoimmune pathologies. Such pathologies are characterized by the release of special antigens, which are attacked by antibodies from immune cells. Reception of immunosuppressors leads to suppression of the mechanism of production of antibodies.

Patients with nephrotic syndrome are prescribed:

1. Ciclosporin orally in an amount of 2.5-5 mg / kg / day;
2. Azathioprine is administered orally at 1.5 mg / kg / day.

• Diuretic drugs are used to eliminate excess fluid accumulation in tissues. The use of diuretics in nephrotic syndrome, edema of the legs is due to an increase in the excretion of fluid from the body by reducing the reverse absorption in the kidneys of salts and water, blocking the reverse absorption of sodium.

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

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

1. Albumin 20% volume of 200-300 ml per day;
2. Plasma - 500-800 ml per day;
3. Reopoliglyukin - by a drop method in a volume of 500 ml per day.

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

1. Penicillin preparations (Ampicillin 0.5 g to six times a day).
2. Preparations of cephalosporin series (Cefazolin 1-4 g / day, 2-3 visits).
3. Preparations of the tetracycline series (Doxycycline 0.1-0.2 g 1-2 times a day).

• To prevent increased thrombosis, patients with nephrotic syndrome should be assigned small amounts of anticoagulants (eg, Fraxiparin in combination with acetylsalicylic acid).

Vitamins in nephrotic syndrome

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

Our body needs a variety of vitamins and minerals daily. To improve the kidney function, it is also required a lot of such substances, but on which of them should be paid special attention, we will tell you:

• Vitamin A takes part in many important reactions: for example, a deficiency of retinol may become one of the factors in the development of pyelonephritis, the formation of microliths in the kidneys. In addition, retinol strengthens the cell membranes in the kidneys, improves metabolic processes: this vitamin can be obtained by eating pumpkin, carrots, nuts.
• Vitamin E promotes excretion of salts in the kidneys, has a diuretic effect, cleanses the urinary tract. Tocopherol is present in sprouts of wheat, unrefined vegetable oils, corn, beans, marine fish.
• Vitamin B _{1 is}  involved in fat and protein metabolism, facilitates the work of the kidneys. Thiamine is present in unpeeled rice, bran, corn.
• Vitamin B ₂  provides the work of glandular systems in the body, improves the state of blood vessels - including kidneys. Riboflavin is present in the composition of milk and eggs, as well as in plant foods (peaches, carrots, spinach, beets, tomatoes, wheat grains).
• Vitamin B ₃  takes part in the processes of cellular energy metabolism, optimizes the protective abilities of the kidneys, prevents the destruction of liver cells. Niacin can be obtained by consuming 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 groats, nuts, bananas, berries.
• Vitamin B ₁₂  improves the processes affecting the nervous system, regulates hemopoiesis, prevents pain in the kidneys. Cyanocobalamin is present mainly in animal products - in meat, liver, eggs.
• Vitamin C is able to strengthen vascular walls, optimize blood coagulability, prevent the development of inflammatory processes. Ascorbic acid is in sufficient quantity in the currant, citrus, cabbage, kiwi, hips, dogrose, tomatoes.

If you prefer to receive the necessary vitamins not from food, but taking them as part of complex drugs and supplements, it is very important not to allow the development of hypervitaminosis. Excess even the most important vitamins negatively affects the function of many organs, including the work of the kidneys. Given this, do not take just a few equivalent vitamins. Carefully study the composition of the supplements and take it according to the instructions and recommendations of your doctor.

Physiotherapeutic treatment

Patients with nephrotic lesion can be recommended:

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

The use of mineral water, mineral baths are considered the most common procedures for nephrotic syndrome. If the patient was operated promptly for pyelonephritis or stone formation in the urinary tract, then the physiotherapy can be prescribed not earlier than 10 days after the operation. This depends on the nature of the postoperative recovery.

Physiotherapeutic procedures are contraindicated:

• in the period of active inflammation;
• in the terminal phase of chronic pyelonephritis;
• with polycystic kidney disease;
• with hydronephrosis in the stage of decompensation.

Alternative treatment for nephrotic syndrome

To avoid undesirable side effects, many people seek help with alternative medicine. Indeed, alternative methods are successfully used to treat many diseases. However, in the case of the nephrotic syndrome, everything is not so rosy: this pathology is very serious, and it is impossible to solve it only by using alternative means. Such treatment is appropriate only at the stage of recovery, after or against the background of drug therapy prescribed by a doctor.

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

• Take 100 g of chopped walnuts and dry figs, mix with 250 g of honey and three lemons passed through the meat grinder (along with the skin). Use a mixture of 1 tbsp. L. Three times a day, 15 minutes before meals. The course of treatment can last a long time, until the state of persistent improvement.
• Take 1 tbsp. L. Corn stigmas, as many cherry tails, pour 0.5 liters of boiling water. Insist to cool down, filter. Take 100 ml 4 times a day, until the symptoms ease. You do not need to prepare the medicine for the future: it is better to prepare fresh infusion daily.
• Mix 2 tsp. Birch leaves, 1 tsp. Strawberry leaves, 3 tsp. Flax. Collect 750ml of boiling water, insist for 40 minutes, filter. Take 100 ml 4 times a day before meals.
• Normalize the condition of patients with nephrotic syndrome berries chokeberry: they should be eaten 10 per day.
• To stabilize the state of health drink infusion on berries hawthorn (1 tablespoon berries for 300 ml of boiling water). Take infusion before meals, 50-100 ml.

These recipes will be able to eliminate the underlying signs of the disease, as they help to remove excess fluid, normalize salt metabolism, lower the level of cholesterol.

Herbal Treatment

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

• Take 10 g of strawberry, birch and nettle leaves, as well as 50 g of flax seeds. Brew in 0.5 liters of boiling water. After cooling, filter and take a little during the day (between meals).
• Prepare this mixture: 3 tbsp. L. Orthosiphon stamen, 3 tbsp. L. Plantain, as many turns and dog rose, 2 tbsp. L. Field horsetail and yarrow, 4 tbsp. L. Flowers of calendula. Plants are brewed in 1 liter of boiling water. Take 50 ml before each meal.
• Prepare a mixture of 1 tsp. Currant leaves, the same number of letters and chamomile. Pour 250 ml of boiling water, insist for half an hour. Take 50 ml 4-5 times a day.

In diseases of the kidneys, juices of a cucumber or a pumpkin are very useful. Such juice can be drunk on an empty stomach on 1-2 tbsp. L. Three times a day (but not more than 100 ml per day).

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

Homeopathy with nephrotic syndrome

Homeopathic treatment in the recovery phase can be as follows:

• With swelling - Barita Carbonic 6, Aurum Metallucum 6, Lahiesis 6
• With drowsiness, headache, nausea - Ammonium album 6
• With anemia - Ferrum Metallicum 12
• With convulsive muscle contractions, damage to the nervous system - Kuprum Metallukum 12, Ammonium album.

In a number of cases, the use of the Echinacea 3 immunostimulator is justified - to accelerate recovery.

Homeopathic remedies do not have side effects (very rarely allergies can be detected, but many homoeopaths consider such cases to be single). Treatment can be done at any age, but the standard dosage does not exist: it is selected by the doctor taking into account the constitutional and other characteristics of the patient. Usually for such appointments, a personal meeting between the homeopathic physician and the patient is required.

Surgery

The surgeon's assistance is rarely required for the treatment of patients with UA. Only in some cases, if acute signs of kidney failure increase, the doctor can prescribe an operative intervention to correct and replace blood supply vessels in the kidneys.

In most situations, it is sufficient to have a medical treatment to get the patient to recover.

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

Nutrition and diet for nephrotic syndrome

Patients are usually assigned a dietary table number 7: this diet will help stabilize metabolic processes, adjust the daily volume of urine, prevent recurrent accumulation of fluid in the tissues.

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

The essence of the change in nutrition is as follows:

• the daily ration should fit within the framework of 2750-3150 kcal;
• food is often taken, but little by little (optimally - 6 times a day);
• roasting of products is excluded;
• limited amount of salt to 2 g / day;
• is included in the diet of protein (in the amount of 1.5 g per kg of body weight);
• limited use of liquids (before the disappearance of edema);
• included in the diet of food rich in potassium (due to treatment with diuretics);
• limited intake of animal fat (up to 80 g / day);
• increases the intake of carbohydrates (up to 450 g / day).

Food, such as baking (if salt or soda is included), fatty meat and fish, fatty dairy products, cheeses, butter and margarine, beans, pickled and salted dishes, 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 with nephrotic syndrome and swelling of the feet

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

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

• Oatmeal milk.

200 ml of milk is poured into a saucepan, brought to a boil, pour 1 tbsp. L. Oats, cook until ready, filter. Take the first few days of 100 ml per day, then gradually increase the volume and bring up to 1 liter. After that again reduce the volume, bring to the original 100 ml. This cycle is repeated 3-4 times.

• Oat broth.

Take one glass of unpeeled oats, pour 1 liter of water and put on fire. Boil for one and a half hours with a small boil. As the boiling water is poured fresh. The broth is then cooled, filtered and placed in a refrigerator. Drink a heated broth 100 ml three times a day between meals.

• Oatmeal infusion.

Rinse half a glass of uncooked oats, fill them in a thermos bottle, pour in boiling water 0.5 liters. Close the thermos lid for 12 hours (preferably - at night). The next morning they beat the resulting mass with a blender and, without adding anything else, they 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.

Such a prescription can also be used to prevent the recurrence of a nephrotic syndrome.

Nephrotic syndrome and flu vaccinations

It is generally accepted that immunoprophylactic measures using active and inactivated vaccines are possible only with confirmed complete recovery on the basis of the absence of clinical signs of the disease and the results of laboratory tests. The issue of vaccination can be considered not earlier than one month after the completion of the therapeutic course. Experts believe that this period may be enough to adequately perceive the body of the vaccine.

Vaccination of children who have suffered a nephrotic syndrome should be carefully thought through by a pediatrician.

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

Immunization of pediatric patients is carried out by a split vaccine, which includes haemagglutinins of the three topical strains of the influenza virus (on the recommendation of the World Health Organization for the current epidemiological season).

With a low degree of immune protection in children, two doses are recommended with an interval of 14 days.

Vaccination with anti-influenza sera is not performed during the period of exacerbation of the disease, as well as in cases of frequent relapses (at a frequency of once every 1.5 years or more often).