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Proteinuria and Nephrotic Syndrome: How We Treat

How is proteinuria and nephrotic syndrome treated?

In cases of significant urine protein loss, a drug called prednisone is used to normalize blood protein and reduce swelling. There is a strict treatment schedule that takes several months, and the dosage is gradually lowered over time until the treatment course is complete. The prednisone should be taken exactly as prescribed to have the best chance of a lasting response.

Response to the prednisone does not happen immediately, so there are times when your child may need to have the protein (albumin) put back into the blood through a vein. It may be necessary to administer albumin intravenously more than once, but this can be done as an outpatient procedure in an emergency department of the hospital. If your child appears very ill, he or she may be admitted to the hospital for treatment, but this is less common.

As long as the kidneys are otherwise working normally and response to treatment continues to keep the urine free of protein, there are no other treatment concerns. However, since any issue affecting the kidneys can cause high blood pressure (hypertension), your child may also need to take medicine for that condition.

In most cases, one treatment course is all that is needed and the condition doesn’t return. Sometimes, the protein leak returns while the prednisone dosage is being decreased or months or years after the treatment stops. When that happens it’s called a “relapse” and treatment must start all over again.

Why choose Children’s Hospital Colorado for your child’s treatment?

Your child’s doctor can refer you to a nephrologist at the Children's Hospital Colorado Kidney Center at any time. Our specialists may continue the treatment your doctor prescribed or recommend additional medications and obtain long term testing of the blood and urine. A referral to the Kidney Center doesn’t mean that prior treatment isn’t working; your child’s doctor may simply feel it’s necessary for you to get direct care from a nephrologist, especially in complicated cases. The pediatric nephrologists at Children’s Colorado have the expertise and experience to recommend alternate treatments when necessary.