Hormone therapy for nephrotic syndrome

Hormone therapy for nephrotic syndrome? I believe this is a problem that many patients with nephrotic syndrome are very concerned about. So how can we completely, safely, and effectively treat it? Let's introduce it to you below.

Hormone therapy for nephrotic syndrome is a commonly used Western medicine treatment method in the field of nephrotic treatment, and it is also a treatment method chosen by many patients in the early stage of treatment for nephrotic syndrome. Hormone therapy for nephrotic syndrome needs to be analyzed in multiple aspects in terms of treatment effectiveness:

　　1。 The initial treatment stage: The efficacy of hormone therapy for nephrotic syndrome is related to the dosage. For newly diagnosed cases, the dose during the initial treatment stage needs to be large enough to induce rapid remission. The dose of prednisone in adults should be 1mg/kg per day, and for individual patients, it can be used up to 1 day if necessary. 5mg/kg。 Some reports suggest that for children between the ages of 2 and 13, the daily dose of prednisone should be 2 to 2. 5mg/kg。 The younger the patient, the greater the dosage of prednisone required. However, the daily dosage of hormones should not exceed 80mg. If the patient's liver function decreases, it is not advisable to use prednisone, but should be changed to prednisolone, which has the same dosage as prednisone. The application of hormones is best taken in the morning.

　　2。 Reduction treatment stage: Usually, high-dose hormones are used for 8 weeks before reduction, with a weekly reduction of 10% of the original daily dose. Adults generally receive 5mg per week If there is no improvement or even deterioration after 8 weeks of high-dose treatment, it is estimated that continuous medication will not be effective (hormone ineffective type) after carefully excluding factors that may also affect the efficacy, such as infection. The dosage should be quickly reduced for short-term discontinuation. If possible, it is best to send it to a higher-level hospital for kidney biopsy If the nephrotic syndrome is partially relieved after treatment (urine protein is reduced by 3g/d or more than half compared to the original level, and symptoms such as edema are alleviated), the hormone should be reduced to a small dose (0.5mg/kg daily for adults and 1mg/kg daily for children), changed to a two-day dose, and taken immediately the next morning Hormone therapy for nephrotic syndrome? If a large dose of hormone is relieved quickly or within 6 weeks, the original dose can be used to consolidate for 2 weeks after the remission, and then the dosage can be reduced. If it is a minor variant of kidney disease, 90% of pediatric patients complete remission after 4 weeks, so it is usually taken for 4 weeks, followed by another 2 weeks to enter the dosage reduction stage. Adults experience slower remission and usually require 8 weeks of hormone therapy to determine whether the hormone is effective in treating nephrotic syndrome. The general course of treatment for the application of hormones should not exceed 3 months. Increasing the dosage of hormones and extending the course of treatment must be done with caution. After reducing the dosage from high to low (approximately 0.5mg/kg per day for adults and 1mg/kg per day for children), the dosage should be changed to two days of medication and taken overnight. After withdrawing to a small dose, the adverse reactions of the hormone will be greatly reduced. At this time, long-term continuous treatment or continuous reduction can be carried out according to the detailed situation. If continuous reduction is decided, it should be emphasized that the reduction should be carried out very slowly. The smaller the dose, the slower the reduction should be. Only in this way can the recurrence of nephrotic syndrome be reduced. The minimum reduction process should also be experienced for at least one month.

　　3。 Continuous treatment stage: ① For those who have only achieved partial remission after initial high-dose hormone treatment, the dosage should be reduced according to the above method. At low doses (1mg/kg for adults and 2-5mg/kg for children), they can be taken for 6 months or more. Usually, this low-dose hormone is used, and its adverse reactions are not significant; If the patient achieves complete remission during low-dose continuous treatment, they should take the original dosage for another 4 weeks after remission, and then slowly and regularly reduce the dosage to the maintenance dosage. Depending on the patient's specific situation, the maintenance dosage should be used for a period of time before gradually reducing the dosage until discontinuation Cases that are sensitive to hormones and quickly achieve complete remission can usually be reduced to the maintenance dose of the hormone as mentioned above, that is, taking prednisone at 0 every other morning. 4mg/kg, which is a physiological requirement with few adverse reactions. It should be taken for about 4 months or more, and then slowly reduced until the medication is stopped Although some patients have achieved complete remission at the initial treatment, they may experience short-term (6 months) recurrence or even relapse when the dosage is reduced to a certain extent (i.e. hormone dependent). Hormone therapy can be used again, and when the dosage is reduced to a maintenance dose for continuous treatment according to the above regulations, the medication can be continued for 12-18 months.

One of the main characteristics of hormone therapy for nephrotic syndrome is that the treatment effect is very obvious. Patients with nephrotic syndrome can receive the treatment effect in a short period of time, and at the same time, some of the symptoms displayed by the patient can be controlled and treated! Perhaps everything has its two sides, and hormone therapy for nephrotic syndrome is also a double-edged sword! We should not only see the advantages of its treatment, but also the shortcomings of hormone therapy for nephrotic syndrome!

Many patients with nephrotic syndrome need to take long-term medication such as prednisone and cyclophosphamide during the persistent treatment process, which can easily lead to severe dependence and reduced drug sensitivity. This type of drug has significant toxic side effects, leading to a decrease in patients' resistance and prolonged treatment. Therefore, hormone therapy for nephrotic syndrome is not limited to just one treatment method!