The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, you must treat the disorder that is causing it. You may need treatment for life.
Keep blood pressure at or below 130/80 mmHg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors may also help decrease the amount of protein lost in the urine.
You may take corticosteroids and other drugs that suppress or quiet the immune system.
Treat high cholesterol to reduce the risk of heart and blood vessel problems. A low-fat, low-cholesterol diet is usually not very helpful for people with nephrotic syndrome. Medications to reduce cholesterol and triglycerides (usually statins) may be needed.
A low-salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem.
Low-protein diets may be helpful. Your health care provider may suggest eating a moderate-protein diet (1 gram of protein per kilogram of body weight per day).
You may need vitamin D supplements if nephrotic syndrome is long-term and not responding to treatment.
Blood thinners may be needed to treat or prevent blood clots.
The outcome varies. The condition may be acute and short-term or chronic and not respond to treatment. The complications that occur can also affect the outcome.
Some people may eventually need dialysis and a kidney transplant.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Herbert Y. Lin, MD, PhD, Nephrologist, Massachusetts General Hospital, Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.