แนวทางในการดูแลรักษาผู้ป่วย nephrotic syndrome

แแแแแแแแแแแแแแแแแแแแแแแแแแแ nephrotic syndrome

Nephrotic syndrome (NS) History and physical examination Basic investigation Serological test

Secondary NS

Primary NS

Rx underlying disease

Pure nephritic urine Normal BP Normal GFR

Nephrotic-nephritic urine Hypertension Decreased GFR Age < 1, > 60 years

Likely steroid responsive Trial of steroid Rx Eradicate infection Prednisolone 1 mg/kg/day (up to 60 mg) for 2 weeks

Consider renal biopsy Rx as recommended

Response

No response

Prednisolone 0.75 mg/kg/day For 4-6 weeks

Prednisolone 1 mg/kg/day Till urine is protein-free 12 weeks

No relapse

Relapse

Response

No response

Taper prednisolone Over 6-12 months

Frequent relapse Steroid dependence

ททททท Practical nephrology 2547 / ททททททททท ททททททททททท

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