Patient discussions
Parents of the affected child should be given a detailed explanation of the condition and taught about the features of a relapse. Home urine dipstick monitoring by parents and immediate reporting of a relapse to the child's physician is vital.
Information for parents may be presented as follows (adapted from KidneyWeb Pro Opens in new window and used with permission):[44]
How is nephrotic syndrome treated?
The main treatment is a drug called prednisone (in tablets) or prednisolone (in a liquid). Sometimes doctors prescribe a diuretic (water pill) to help with the swelling. Most children can stay at home. A few children have to stay in the hospital for a few days. Your child will take the medicine until the protein is gone from the urine. Then he or she will take smaller doses of the medicine for a few more weeks. You can test your child's urine at home. A doctor or nurse will teach you how. It's easy: check your child's urine any time you think he or she appears swollen or puffy; check your child's urine when he or she gets sick (e.g., when he or she has a cold or the flu).
Avoiding salt will help reduce the swelling. Don't add salt to your child's food. Try to give your child foods that are low in salt. Children taking this medicine may want to eat a lot. Give your child healthy, low-fat snacks. Your child should eat a normal amount of protein. Your doctor or dietician can tell you more about low-salt foods and healthy snacks.
Will it come back?
Most children with MCD will have several episodes during their lives. When MCD comes back, it's called a relapse. These relapses are treated with medicine much like the first time. Relapses often happen when the child gets sick with a cold or another illness, but they may also happen when the child is well. We don't know what causes relapses. Relapses usually get better with treatment, the same way the first episode did. Most children with MCD will stop having relapses during their teenage years. A few children continue to have relapses as adults.
Will my child need a kidney biopsy?
In a biopsy, a doctor takes out a tiny piece of the kidney. This piece is then studied with a microscope. Most children with MCD do not need a kidney biopsy. The kidney biopsy can help your doctor decide on the best therapy for your child. Your doctor may suggest a kidney biopsy if:
Your child has many relapses
Your child does not improve with treatment
Your doctor thinks your child might have a different disease (not MCD).
Will my child always have to take medicine?
Most children can stop taking medicine after they get better. You should only stop the medicine when your doctor tells you to. It's very important to take the medicine the way the doctor prescribed it. If you stop giving the medicine suddenly, your child can become very ill. If you need more medicine, call the doctor's office.
Your child will have to start taking medicine again if he or she has a relapse in the future.
If your child has many relapses, he or she may need a different treatment to help prevent relapses. There are several medicines available.
Does nephrotic syndrome cause kidney failure?
People with nephrotic syndrome do not have kidney failure. Their kidneys just don't work properly when they lose protein. Most children with nephrotic syndrome never develop kidney failure. Most never need dialysis or a kidney transplant, but a few children do. It's important to see the doctor regularly. He or she will watch for any early signs of kidney trouble and tell you about possible treatments.
Your child should not get certain vaccines while taking this treatment. He or she should not get live vaccines such as varicella (chicken pox) or MMR. Most other vaccines are okay. Ask the doctor before your child gets any vaccines.
Children with nephrotic syndrome have a higher risk of getting infections. You must call your child's doctor right away if your child:
Has stomach pain
Has a fever (temperature >101°F (38.5°C))
Is around someone who has chicken pox.
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