Primary Nephrotic Syndrome Treatment Options

Treating primary Nephrotic Syndrome includes preserving kidney function as well as taking steps to reduce high blood pressure, swelling, high cholesterol, and the risks of infection. Treatment may vary from patient to patient, depending on age, disease, genetic results, kidney function and how well they respond to steroids.

Prednisone (steroids)

Usually, patients are treated with prednisone first. Prednisone belongs to a class of drugs known as corticosteroids. Corticosteroids work by decreasing the body’s immune system response to various diseases or conditions that produce symptoms such as swelling, inflammation, and allergic-type reactions.

To learn more about prednisone and Nephrotic Syndrome, please visit the NephCure website.

Second-line treatments

If steroids fail to cause remission (usually within 8-12 weeks), or if a patient becomes “steroid dependent,” a second-line treatment may be tried. Some second-line treatments include:

Adrenocorticotropin (ACTH Acthar Gel)
Angiotensin II receptor blockers (ARBs)
Angiotensin-converting enzyme (ACE) inhibitors
Cyclophosphamide (Cytoxan)
Cyclosporine (Neoral)
Methylprednisolone (Solu Medrol)
Mycophenolate (MMF, Cellcept, Myfortic)
Plasmapheresis (Liposorber)
Prograf (Tacrolimus)
Rituxan (Rituximab)

Clinical Trials

There are a number of other potential treatments that may reduce proteinuria (protein in the urine) in primary Nephrotic Syndrome patients. You can use this website to find a list of clinical trials for which you may be eligible. Ask your doctor about these trials and whether they might be right for you.

Additional Information

Your doctor may recommend a combination of treatments. Sometimes, a specific diet and other lifestyle changes will be recommended in lieu of or in addition to medications.

All medications have different side effects, so the treatment chosen by you and your doctor should take side effects into account. If you are unhappy with the side effects you are experiencing, talk to your doctor about other options you may have.

*Note: The decision to prescribe a medication is the responsibility of your physician/primary care provider based on his/her evaluation of your condition. The above is meant for informational purposes only. Discuss this information and all information about drugs/medications with your physician before starting or stopping any medication.

Frequently Asked Questions

Nephrotic Syndrome is not a disease itself, but rather a group of signs and symptoms that result from damage in the part of the kidney that filters blood (glomeruli).

Common symptoms include:

  • Foamy urine (called proteinuria) caused by protein “spilling” into the urine
  • Severe swelling in parts of the body, most noticeably around the eyes, hands, feet, and abdomen (called edema)
  • Weight gain due to a buildup of extra fluid
  • Fatigue
  • Loss of appetite
  • Low levels of protein in the blood (hypoalbuminemia)
  • Higher than normal fat and cholesterol levels in the blood (hyperlipidemia)

Nephrotic Syndrome can typically be diagnosed with a urine test.

Nephrotic Syndrome can be “primary” or “secondary” in nature.

Diseases that affect only the kidneys are called primary causes of Nephrotic Syndrome. Doctors often call these diseases “idiopathic,” which means that they arise from an unknown cause. Some of these diseases include:

  • Minimal Change Disease (MCD) – most common in children
  • Focal Segmental Glomerulosclerosis (FSGS)
  • Membranous Nephropathy (MN) – most common in adults
  • IgA Nephropathy (IgAN)

Secondary Nephrotic Syndrome is caused by an underlying, systemic condition like diabetes, lupus, HIV, and others.

The Kidney Health Gateway is a website owned and operated by NephCure Kidney International. The purpose of this website is to help patients with rare forms of primary Nephrotic Syndrome get connected to expert care and cutting-edge treatment options. By answering a few questions about you or your loved one’s condition, we can provide you with a list of clinical trials and/or expert doctors in your area.

If you have additional questions, please visit or email


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