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What is the treatment for nephrotic syndrome?

Q: My 3 years old daughter is suffering from nephrotic syndrome (minimal change disease) for the last 6 months, which is repeated for the second time. She has been taking Prednisolone for the last 3 months. But for the last 2 months her urine test has not shown any discharge of protein from her urine. The doctor has reduced her medicine intake to 5 ml (Prednisolone) on alternate days.

  1. Is this disease curable?
  2. How long should she take the medicine for?
  3. Is there any side effect of taking Prednisolone?

A:Your daughter most likely has minimal change glomerulonephritis, which responds well to Prednisolone. The only problem is that about 50% children have relapse and 50 % of these have frequent relapses. Usually the disease recovers in most children as they grow but how long will medicines have to be given is difficult to predict. She should take one course for 12 weeks and then taper it slowly in another 4-6 weeks. Long term side effects of prednisolone are on bones, cataract, growth retardation and cosmetic effects, however if steroids are given intermittently the catch up recovery of many of these do occur. I do hope your daughter does not have to take it for too long. There are other drugs like cyclosporine/Tacrolimus and cytoxan which can be used in some select patients who do not respond or who show frequent relapses or become prednisolone dependent.

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