Medications and Treatments
This page is a source of medication options available currently in the UK and we will do our best to keep it updated. It’s important to strictly follow the advice of your consultant regarding taking of medications and dosages. If you forget what has been said to you (don’t worry we’ve all done it walked out of the consulting room forgotten what said to us, it’s always best to check), or if you are concerned about side effects always check with your consultant, or ring the ward for advice giving full name, hospital number and be prepared to give a contact number if staff have to call you back.
The first line of treatment for nephrotic syndrome is steroids (prednisolone), but additional treatments may also be used if someone develops significant side effects, or frequently relapsing. Your consultant will request you keep a diary of daily dip-stick results measuring the level of protein in your urine , dipstick recordings should be made as follows negative, trace+1,+2,+3 (some sticks add a +4). Dipstick readings should be taken first thing in the morning. Please note down any health concerns, or days feeling unwell too. Please bring diary of recordings to outpatient appointments.
Important -If you are leaking 3+ protein for three consecutive days, or leaking 2+ over several consecutive days. Always contact your nephrologist if you are relapsing as you may need to be prescribed steroids, or an alteration in your current prescription and repeat bloods to make an assessment of your health.
Your daily weight should also be recorded and possibly blood pressure readings if your consultant is concerned. Your consultant will advise you what your BP parameters should be, if you find your BP reading is lower, or higher than permitted its important you seek advice urgently. If you do not respond to steroids after a four week period you will be referred to a nephrologist for further tests such as a kidney biopsy and specialist treatment.
Albumin infusions
The protein which is mostly lost in nephrotic syndrome is called albumin. If symptoms are severe, you may be admitted to hospital to receive albumin infusions. Albumin will be slowly administered to the blood over a few hours through a thin plastic tube called a cannula, which is inserted into a vein in the arm.
A helpful and practical guide for parents giving medication can be found on https://www.medicinesforchildren.org.uk
Other medication options
Other medications may be used alongside, or in place of steroids if you do not gain remission, or it is not maintained with steroids, or if you experience significant adverse side effects. Your consultant will be able to advise which will be the most appropriate to give if steroids have not been successful inducing remission.
Medication options may include:
Levamisole
Tacrolimus
Mycophenolate
Cyclophosphamide
Cyclosporine
Rituximab
Penicillin
Penicillin is an antibiotic, and may be prescribed during relapses to reduce the chances of an infection.
Diuretics
Diuretics may also be given to help reduce the fluid build-up. They work by increasing the amount of urine produced.
Steroids
Those diagnosed with nephrotic syndrome for the first time are normally prescribed a 4-week course of the steroid medicine prednisolone, then the dose is tapered down slowly to avoid any withdrawal symptoms. Steroids should stop protein leaking from your child's kidneys into their urine. When prednisolone is prescribed for short periods, there are usually no serious or long-lasting side effects, however both children and adults can experience:
Increased appetite
Weight gain
Flushed red cheeks
Mood changes
Most children and adults respond well to treatment with prednisolone, with the protein often disappearing from their urine and the swelling going down within a few weeks. This period is known as remission. If you find you are on frequent doses of steroids it’s advisable to book regular optician’s appointments as steroids although rare can cause cataracts.