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  5. I've been treated for nephrotic syndrome for two years and was on steroids followed by Tacrolimus. My proteinuria persists after medication withdrawal. What should I do?

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I've been treated for nephrotic syndrome for two years and was on steroids followed by Tacrolimus. My proteinuria persists after medication withdrawal. What should I do?

Asked by Female, 45 · 1 month ago

Dr Y Thulasi

Dr Y Thulasi

Pharm-D (Post baccalaureate)

1 month ago

If you continue to have proteinuria after taking tacrolimus and steroids, the disease may still be active. If this is the case, you should contact your nephrologist right away for a reevaluation, which may involve urine testing and, if it hasn't already been done, a kidney biopsy. To lessen protein loss, treatment may need to be continued or switched to another immunosuppressants?in addition to ACE-inhibitors/ARBs.
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Other Related topics like...

What tests should I get for kidney health?Can diet help reduce my proteinuria?Should I see a nephrologist now?Is kidney biopsy necessary for me?What medications might help my condition?

  1. Evaluation of Persistent Proteinuria

    • Reassess kidney function and proteinuria levels with tests like 24-hour urine protein and serum creatinine.

  2. Possible Causes

    • Persistent proteinuria may indicate ongoing kidney damage or incomplete remission. Rule out secondary causes.

  3. Role of Kidney Biopsy

    • A repeat kidney biopsy might be necessary to evaluate current kidney pathology and guide treatment.

  4. Treatment Options

    • Consider re-initiating or adjusting immunosuppressive therapy under nephrologist supervision. Supportive treatments include blood pressure control with ACE inhibitors or ARBs.

  5. Specialist Consultation

    • Close follow-up with a nephrologist is crucial for personalized management.

  6. Monitoring and Follow-up

    • Regular monitoring of proteinuria, kidney function, and medication side effects is essential.

  7. Patient Education and Lifestyle

    • Maintain a healthy weight, avoid nephrotoxic drugs, and control blood pressure and blood sugar if applicable.

Answered 1 month ago