Clinical features: It is a syndrome comprising of proteinuria (> 3 g/24 hours), hypoalbuminemia (< 30 g/litre) and oedema. Nephrotic Syndrome may be due to primary glomerular disease or secondary to other diseases including infections.
Treatment guidelines
• Treat underlying cause where applicable
• Allow bed rest
• Give high protein diet
• Encourage consumption of potassium rich foods e.g bananas, papaws, potatoes and pigeonpeas.
• Restrict salt and water intake
• Try and induce diuresis
Drug of choice |
Frusemide |
| |
40 - 200 mg every 12 hours. |
Adult |
Measure urea and electrolytes. Restrict fluid to 1 litre daily until diuresis is achieved. In case oedemas gross and no response is observed you may consider adding. |
| |
Prednisolone |
| |
40 - 60 mg once daily. Tail off the dose over 6 - 8 weeks to avoid a relapse. |
Anticoagulant if immobile
Heparin 5000 units three times a day.
Search for underlying cause - exclude SLE.
Children
Follow similar schedule with the following dosage
Frusemide 1 mg/kg body weight every 24 hours
Prednisolone 1 mg/kg body weight daily for 6-8 weeks, tail the dose to avoid relapse.
Heparin 15-25 units/kg body weight by IV
OR
250 units/kg body weight subcutaneous inj. every 12 hours.
