The use of hormones in nephrotic syndrome?

  Hormones are still the drug of choice to induce remission of nephrotic syndrome, and are generally used mostly in medium-acting glucocorticosteroid preparations, such as prednisone (or prednisolone).  1.The clinical pharmacological effects of hormones: inhibition of inflammation, inhibition of immune effects, inhibition of aldosterone and anti-diuretic hormone effects.  2, the indications for hormones: (1) microscopic nephropathy and mild thylakoid proliferative glomerulonephritis: sensitive to hormones; poor efficacy and recurrent patients can add cytotoxic drugs.  (2) Early membranous nephropathy: 60%-70% can be relieved by active treatment with hormones and cytotoxic drugs.  (3) Thylakoid capillary nephritis, focal segmental glomerulosclerosis and severe thylakoid proliferative nephritis, with poor efficacy.  3. Contraindications to hormones: (1) psychosis; (2) active peptic ulcer; (3) infections not controlled by antibacterial drugs; (4) severe hypertension; (5) osteoporosis, etc.  4, the correct use of hormones: (1) the starting amount of sufficient: commonly used drug is prednisone 1mg/kg.d, morning dose, oral 8-12 weeks, most domestic physicians advocate the maximum amount of not more than 60mg / d. (2) slow reduction: after full treatment every 1-2 weeks to reduce the original dosage of 10G, when reduced to 20mg / d symptoms are prone to recurrence, should be more slowly reduce the dosage.  (3) Long-term maintenance: Finally, the minimum effective dose (10mg/d) is used and maintained for about six months more. According to the patients’ response to hormone treatment, they can be divided into “hormone sensitive (NS remission after 8-12 weeks of medication)”, “hormone dependent (hormone reduction to a certain degree of relapse)” and “hormone resistant (hormone The latter two should be treated with immunosuppressive drugs.