7/30/2019 Nephrotic Syndrome - Resident Elevator Notes
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Management
1. Bed rest, monitoring U/E, BP, fluid I/O charting, weight
2. Fluid restriction 1-1.5L/day salt restriction high protein
diet
3. Diuretics Frusemide 80-250 mg PO spironolactone Aim for loss
of 1kg/day Occasionally high dose frusemide + IV salt-poor albumin
to
promote diuresis. However, risk of renal failure secondary
tohypovolaemia with over diuresis
4. Chronic nephrotic
syndrome
Consider reducing proteinuria with ACEI or cyclosporine
5. Hyperlipidaemia Consider statin. Usually improves with
resolution of nephrotic syndrome
6. Hypertension Conventional regimens7. Anticoagulation
Prophylactic heparin for immobile PTs
Warfarin for symptomatic thrombosis8. Infections Prophylactic
ABx
Pneumococcal vaccination during remission
9. Mx of minimal changenephropathy inchildren
High dose corticosteroids cyclophosphamide / cyclosporine in
steroid dependant NS
Digitally signed by DR WANA HLA SHWE
DN: cn=DR WANA HLA SHWE, c=MY,
o=UCSI University, School of Medicine, KT-Campus, Terengganu,
ou=Internal MedicineGroup, [email protected]
Reason: This document is for UCSI year 4
students.Date: 2009.02.24 10:17:10 +08'00'
