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Treatment for recurrent NEPHROTIC SYNDROME on STEROIDS.

Resolved Question:

my sister is having nephrotic syndrome
in 2013 october we came to know about the syndrome and we did the treatment
she was taking steroids tablets for 3 months and it stopped
3 days back she did her 24hours urine test and it has attacked again and the doctor has asked to take the steroids again

can u please give me a solution for this


Category: Nephrologist

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Category: Pediatric Nephrologist
Dr. Sree Bhushan Raju is online now

Expert:  Dr. Sree Bhushan Raju replied 4 Days.

Hello,
Thanks for query at DoctorSpring.com
I understand your concern.
This condition is called ' nephrotic syndrome ' where the patient loses protein in the urine. Many a times it is genetic and if patients are young, they respond to steroids . It is characterised by remission (improvement) and relapses (reappearance) and usually it respond to steroids.
How old is your sister?
Feel free to discuss further
Regards


Patient replied :

Hello Doctor, She is 22 years old. Actually in October 2013, she took a biopsy test and report was FSGS. this time when she went for a general check up there was NO symptoms of edema. Our nephrotic doctor told us to check 24 hours urine test in which the report showed protein leak.
So she's going to get married in 3 months and our main concern is after how much time will it repeat again, is it safe to get married now, will there be any complications?
I have also looked up at chinese herbal medicine and dr.shah's homoeopathy treatment, is it any good for this particular syndrome.
Kindly reply
Thank You


Expert:  Dr. Sree Bhushan Raju replied 3 Days.

Hello,
Prognosis of FSGS depends on type of histological variant. Can you please upload biopsy and urine anaysis report of your sister?
Also, is there any family history?
Is there any other associated disease like diabetes, hypertension?
Feel free to discuss further


Patient replied :

Hello Doctor
There's no family history of this particular syndrome. She has no diabetes or hypertension. I will upload the reports of her.



Expert:  Dr. Sree Bhushan Raju replied 2 Days.

Hi
FSGS is sometimes a genetic disorder which doesn't mean that someone in the same family should get affected. But, there can a one who is a blood related person to the patient with FSGS which called as' familial FSGS'. As per the history given by you, you also need to evaluate her for secondary causes of FSGS. She would respond to steroids and done times other immunosuppressive drugs.
She can get married soon depending on the duration of remission. Wait for few years, whether she gas s risk to develop kidney failure during her lifetime will depend on the amount of protein in urine initially, creatinine etc.
Also, can you submit the very first reports just before kidney biopsy along with kidney biopsy reports so that we can stratify the risk profile for developing kidney disease in the future.
Feel free to discuss further


Patient replied :



Hello Doctor
i have her old reports but for some reason it's not uploading here. Her old report which is around 1 year and 2 months shows that her protein in urine was 1484 mg / 24 hours and now it shows 988mg / 24 hours
so ca you please comment on this difference
Kindly reply

Thank You


Expert:  Dr. Sree Bhushan Raju replied 1 Day.

She is in to partial remission and has good prognosis. You need not worry . You wait till she gets in to complete remission ( less than 500mg per day)
Regards.


Dr. Sree Bhushan Raju
Category: Pediatric Nephrologist
Experience: 
FISN : Fellowship of Indian Society of Nephrology(ISN), 2012
FIACM : Fellowship of Indian Association of Clinical Medicin(IACM), 2012
FICP: Indian College of Physicians Association of Physicians of India, 2012
Fellowship: DM, DNB, All India Institute of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, Nizam's Institute of Medical Sciences, 1998
Medical School: MBBS, Gandhi Medical College, 1994
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