Managing nephrotic syndrome

The main treatment for nephrotic syndrome is steroids, but additional treatments may also be used if a child develops significant side effects.

Most children have relapses until their late teens and need to take steroids when these occur.

Your child may be referred to a childhood kidney specialist (paediatric nephrologist) for tests and specialist treatment.


Children diagnosed with nephrotic syndromefor the first time are normally prescribed at least a four-week course of the steroid medicineprednisolone, followed by a smaller dose every other day for four more weeks. This stops protein leaking from your child's kidneys into their urine.

When prednisoloneis prescribed for short periods, there's usually no serious or long-lasting side effects, although some children may experience:

  • increased appetite
  • weight gain
  • red cheeks
  • mood changes

Most children respond well to treatment with prednisolone, with the protein often disappearing from their urine and the swelling going down within a few weeks. This period is known as remission.


Diuretics, or "water tablets", may also be given to help reduce the fluid build-up. They work by increasing the amount of urine produced.


Penicillin is an antibiotic, and may be prescribed during relapses to reduce the chances of an infection.

Dietary changes

You may be advised to reduce the amount of salt in your child's dietto prevent further water retention and oedema. This means avoiding processed foods and not adding salt to what you eat.

Get tips on how to cut down on salt .


Children with nephrotic syndrome are advised to have the pneumococcal vaccine. Some children may also be recommended the varicella (chickenpox) vaccination between relapses.

Live vaccines, such as MMR , chickenpoxand BCG , shouldn't be given while your child is taking medication to control their symptoms.

Additional medication

Other medications may be used alongside or in place of steroids if your child's remission can't be maintained with steroids or they experience significant side effects.

Additional medications that may be used include:

  • levamisole
  • cyclophosphamide
  • ciclosporin
  • tacrolimus
  • mycophenolate
  • rituximab

Albumin infusions

Most of the protein lost in nephrotic syndrome is a type called albumin. If your child's symptoms are severe, they may be admitted to hospital to receive albumin infusions.

Albumin is slowly added to the blood over a few hours through a thin plastic tube called a cannula, which is inserted into one of the veins in their arm.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 21 Dez 2018