Treatment-nephrotic syndrome

(NEJM 2013;368:10)

• General: protein suppl.; diuretics for edema; treat hyperlipidemia, Na restriction (<2 g/d)

• ACEI or ARB: ↓ proteinuria → slow nonimmunologic progression of renal disease

• 1° glomerular: steroids ± rituximab or cytotoxic therapy (CJASN 2014;9:1386; NEJM 2019;381:36)

• Secondary causes: treat underlying disease

• Watch for malnutrition (protein loss), consider anticoag if albumin <2.5 in membranous (KI 2014;85:1412), infection (esp. encapsulated organisms b/c loss of Ig)