Q: I am a 23 years old man suffering from nephrotic syndrome and minimal change disease for the last 6 months. I am taking steroids. Can steroids be discontinued after tapering or totally? I have been put on another drug too and the doctor says the body has become steroid resistant. Please suggest a diet for the same.

A:Minimal change disease [MCD] normally responds to a course of steroids given over period of 4 months. Once the disease responds as obvious from reduction in the amount of protein in the urine, steroids can be tapered to be discontinued. However, if you continue to have increased protein in urine, then the disease is deemed as steroid resistant and that mandates addition of immunosuppressive medication like Cellcept. Also, one would need to repeat the kidney biopsy to study and reassess the type of underlying kidney disease if the patient with initial diagnosis of MCD fails to respond to steroid over 4 month period as probably in your case.

Diet should include daily protein intake of 50-55 grams, common source being milk, cheese, yogurt, fish and meat (if non-vegetarian) in addition to cereals, pulses, nuts and legumes. Strict blood pressure control and avoidance of potential kidney toxic medications is also important to undertake.