Treat Nephrotic Syndrome with Hormones

Hormone is commonly used in treating nephrotic syndrome(NS) in western medicines and is often chosen by patients at the early stage of treatment.The curative effect of hormones in treatment process should be analyzd from the following aspects.

Primary treatment stage.
The curative effect of hormones has something to do with the dose. At the first,the dose should be large enough to alleviate the condition quickly. The dose of prednisone(pred) for the adults is 1mg/kg,as for the individual patients,the dosage can be increased to 1.5mg/kg. It is reported that the dose of prdnisone for children aging from 2 to 6 years old should be 2～2.5mg/kg.The younger the children are ,the greater the pred will be. It is worthwhile to note that the daily consumption of hormone less than 80mg is better. It is better to take the hormone in the morning.
The stage of reduction treatment
After about 8 weeks of using large dose of hormones,the dose should be reduced to 10% of the previous amount,that is 5mg for the adults. There are three points should be noted. First,if patient’s condition is not improving or even becomes worse after 8 weeks,excluding the factors such as infections which may affect the curative effect,continuous medication may be of no avail(hormone-ineffective type),the patients should reduce the consumption of hormone quickly in order to stop taking bills temporarily. If it is allowed,renal biopsy should be taken for a further and detailed check.
Second,if the symptoms such as urine protein reduced more than a half and swelling is alleviating,then amount of hormones can be reduced to 0.5mg/kg for the adults and 1 mg/kg for the children. The hormones can be taken every two daysin the morning.
Third,if the patients recover quickly because of the large dose of hormones,or the curative effect is seen within 6 weeks,the hormones can be used for another two weeks to consolidate the condition and then reduce the dosage. Generally speaking,the course of hormones is less than 3 months ,the increase of dosage and prolonged treatment should be operated carefully.
Persistent treatment period.For the primary large dose of hormones,some patients may become better and the dose can be reduced to small amount(adults:1mg/kg，children:2～2.5mg/kg) for sis months or longer. During the persistent period treatment,if the patients is in remission,the patients should take the medicines for another four weeks and then reduce the dose gradually till stop taking them.
For the hormone sensitive patients who achieve complete remission,they usually can reduce the dose to the maintenance level,that is,pred 0.4mg/kg,which is the necessary amount for the patients. There is a condition that the patients achieve in complete remission when they use hormones at first ,but the disease relapse in a short period or relapse because of reduction of dose. Under this circumstances,hormones can be used again according to the previous prescription for 12 to 18 months.

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