Question
The child has been suffering from nephrotic syndrome for 5 years, experiencing frequent relapses, primarily treated with prednisone. Relapses occur when the dose is reduced to one tablet or half a tablet. There has been no recurrence for a year now. Uncertain about future occurrences. Please advise experts. Thank you!
Answer
Diet: Generally, no dietary restrictions are necessary, but protein intake should be increased moderately; individuals with nitrogenous blood disease should limit their intake. For children with edema and hypertension, sodium should be restricted; water intake should be limited in severe cases of edema. 2 If infection is present, administer antibiotics that do not harm the kidneys (such as penicillin). 3 Diuretics: Take oral double hydrochlorothiazide or spironolactone; furosemide may be used if necessary. 4 Blood plasma and blood proteins can increase serum protein levels and alleviate edema. 5 Hormonal Therapy: Prednisone is commonly taken orally, which has diuretic and anti-edema effects and reduces proteinuria. The daily dose is divided into 3 to 4 servings and taken over a period of 4 weeks. If urine protein remains negative (no protein detected in urine tests) for three consecutive times within 7 to 10 days, the dose can be taken once a day in the morning every other day. Continue this for another 4 weeks, then reduce the dose by 2 to 4 weeks each time until discontinuation, with a total treatment duration of 4 to 6 months. If proteinuria does not disappear within the first 4 weeks of treatment, the treatment period should be extended; it should not be changed to once every other day in the morning. Continue with the original dosage for another 4 weeks. If urine protein remains negative for three consecutive times (within 7 to 10 days) within 8 weeks, it can then be changed to once a day in the morning every other day, followed by another 4 weeks, then reduce the dose by 2 to 4 weeks each time until discontinuation, with an extended total treatment duration of up to 9 to 12 months.