How to Prevent the Recurrence of Nephrotic Syndrome?

• The recurrence of Nephrotic Syndrome(NS) is related with pathological category and heredity, etc. For the patients who are sensitive to hormonotherapy, their recurrence rate is relatively low. But one thing that needs notice is, even for those infant patients with NS who are sensitive to hormonotherapy, only 30% of them would not recur after the first attack of the disease, and 40% would recur for 1～3times after the first attack, and the remaining 30% would recur for about several years.

  According to the above mentioned reasons, we should accomplish the following points for the prevention of the recurrence of NS in children:

  1. Medications According to the Rule. At present, the mid-long term hormone therapy is most adopted in the world, so is it in China. “Prednisone” and “Metacortandracin” are generally used. At the beginning, the dose is 2mg per kilogram of body weight per day with its taken at a draught or taken divided into two or three times after meal. After some alleviations(generally about 4～8weeks), continue to treat for two weeks with original doses. Afterwards, gradually reduce the doses by 10% every two weeks till drug withdrawal. This course of treatment generally needs 6～9months, among the process, there are some principles: The doses and the treatment course must be enough; and the reducing course of the medicine must be slow. So parents should not act on their own, such as reducing drugs blindly, or immediately withdrawal of drugs only if seeing that the symptoms are slight alleviated.

  2. The infant patient with frequent recurrence can appropriately extend the time of hormonotherapy under the guidance of doctors, however, parents themselves should not extend the course of hormone therapy voluntarily, because thus could possibly run it backfired.

  3. Prevent Infection. Take a treatment in time if catching cold, etc, especially the skin infection and urinary infection, which are easily neglected. So, parents should be on the alert, and receive a treatment if there are some symptoms.

  4. Since vaccination could possibly result the recurrence of the disease, so if the patients need to vaccinate during the treatment, try to avoid the use of live vaccine. During the process of abundant uses of hormones and immune inhibitors, the vaccination time should be accordingly extended and postponed, which usually be conducted half a year after the alleviation of the symptoms.

  At last, sensible eating and appropriate exercises are also important in the prevention of recurrence. For the patients with edema, or with abundant urinary protein, or with hypertension, they should stay and relax in bed until the improvement of symptoms, then they could participate in appropriate exercise instead of strenuous exercise, otherwise recurrence would be induced. The intake of salt should generally not be restricted only when there is edema or hypertension. Regarding the intake of protein in the diet of babies suffering nephropathy, the traditional practices claim the adopt of high-protein diet so as to complement the protein lost in urine, however, recent years have seen that, when there is no relief in nephropathy, the intake of excessive protein-highly diet seemingly has no help in the increase of plasma albumin, instead, that would result the more leakage on protein in urine, as well as aggravate the damage to glomerulus and boost the glomerulosclerosis. So, moderate protein-contained diet is suggested in clinical and , recommend 2g per kilogram of body weight per day and the protein should be the quality protein with high biological value in such food as milk, fish, egg, lean meat and meanwhile, avoid such allergic food as shrimp, crabs, etc.

  The repeated recurrence of disease could influence the infant patients’ physical and psychological health, so parents should have more understanding and knowledge about nephropathy, and actively cooperate with the treatment so as to prevent the recurrence. 

• TAG: Childhood Nephrotic Syndrome Causes

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