[Treatment of nephrotic syndrome in the adult].
Approximately two-third of the cases of the adult nephrotic syndrome is caused by a primary glomerular disease, while the remaining one-third is caused by diabetes mellitus, autoimmune diseases, or amyloidosis. There are two different therapies to treat the syndrome: a general and a special treatment. The general treatment includes administering an appropriate diet (reduced intake of proteins and salt), use of diuretics and lipid-lowering drugs (primarily statins) and initiation of anticoagulant treatment, if required. It is generally necessary to administer angiotensin-convertase-enzyme inhibitors and angiotensin receptor blockers as well as initiate a symptomatic treatment to mitigate the loss of special binding-proteins. The special treatment involves the administration of immunosuppressive and cytostatic drugs. This therapy can be initiated only after the evaluation of renal histology and the overall risk status of the patient. Steroids are still the basic immunosuppressive drugs. Their use can be supplemented with other immunosuppressive or cytostatic treatment. In therapy resistant cases, however, new drugs like mycophenolate mofetil or rituximab can also be applied.
Gero
László
L
Semmelweis Egyetem, Altalános Orvostudományi Kar, I. Belgyógyászati Klinika, Budapest.
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000925:Anticoagulants / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D004039:Diet, Sodium-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage; D004232:Diuretics / Q000627:therapeutic use; D015432:Glomerulonephritis, Membranoproliferative / Q000628:therapy; D015433:Glomerulonephritis, Membranous / Q000628:therapy; D005923:Glomerulosclerosis, Focal Segmental / Q000628:therapy; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009402:Nephrosis, Lipoid / Q000628:therapy; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D000069283:Rituximab
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000925:Anticoagulants; D000970:Antineoplastic Agents; D004044:Dietary Proteins; D004232:Diuretics; D000960:Hypolipidemic Agents; D007166:Immunosuppressive Agents; D000069283:Rituximab; D009173:Mycophenolic Acid