Experts explain the treatment of refractory nephrotic syndro2017-06-06 10:21
With the continuous progress of medical research and treatment of nephropathy gradually improved, refractory nephrotic syndrome refers to the treatment of remission in 8 to 12 weeks in the disease has not yet enough hormone, or although in the hormone reduction after treatment in patients with recurring nephrotic syndrome.
Refractory nephrotic syndrome generally include the following: (1) Corticodependence, refers to the application of glucocorticoid therapy, urine protein can significantly reduce or even negative, but in the reduction process (has not yet reached the maintenance dose) of nephrotic syndrome and recurrence, and then increase the glucocorticoid dose (still effective; 2) glucocorticoid resistance, a sufficient Glucocorticoid (adult per kilogram of body weight per day LMG prednisone) invalid 12 weeks of treatment in patients with nephrotic syndrome; (3) glucocorticoid intolerance, refers to patients with active peptic ulcer, active tuberculosis, hepatitis, diabetic nephropathy and other reasons can not be bad the reaction of hormone tolerance in patients with nephrotic syndrome; (4) recurrent, refers to patients with nephrotic syndrome after six months after remission relapse within 2 or more times, or recurrence within 1 years more than 3 times. Refractory nephrotic syndrome accounted for all patients with nephrotic syndrome 1/3, for treatment of these patients usually need to use a combination of corticosteroids and immunosuppressive agents, timely treatment of infection and acute renal embolism, not congruent complications. So, how should be Refractory Nephrosis Treated?
We should clarify refractory nephropathy is difficult to treat intractable or false. It's hard to treat patients with pathological type is not sensitive to treatment, such as membranous nephropathy, C1q nephropathy, mesangial proliferative glomerulonephritis, focal segmental glomerulosclerosis. "False refractory" means that after a certain number of pathogenic factors are located, nephrotic syndrome becomes sensitive to hormones or spontaneously alleviated.
It's hard to cure for nephropathy, can take appropriate measures according to different situations, many patients can get good results. Clinical experience shows that for single hormone remission or relapse cases can be used in 2-4 weeks after hormone plus other immunosuppressive agents in the hormone reduction, such as cyclophosphamide, azathioprine, mycophenolate sodium, cyclosporine, tacrolimus, of course, the drug must have experience in medicine under the guidance of doctor. Studies have shown that combined use of immunosuppressive agents can increase the rate of remission. In addition, in the application of immunosuppressive treatment process, patients should pay attention to rest, prevent colds, pay attention to warmth, enhance the body resistance, often infection and fatigue, is also an important cause of disease recurrence. It should be said that the vast majority of patients after the doctor's careful treatment, refractory nephrotic syndrome can be recovered.