Materiały źródłowe

• #1 Nephrotic Syndrome Symptoms, Causes, Diet, Treatment, Diagnosis

  https://www.emedicinehealth.com/nephrotic_syndrome/article_em.htm

  It is possible to prevent nephrotic syndrome in some people, but not in others, depending on the treatability of underlying causes. […] It may be possible to prevent some types of the disease by stopping the underlying cause (prevention of kidney trauma, avoiding heroin use) while it’s impossible to prevent the other types (genetic cause). In general, if it’s possible to prevent the underlying cause, it’s possible to prevent the disease.

• #2 Nephrotic Syndrome: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5989-nephrotic-syndrome

  You cant prevent nephrotic syndrome. However, you can improve the symptoms of nephrotic syndrome by treating its cause and making changes to your diet.

• #3 Nephrotic Syndrome Symptoms, Causes, Diet, Treatment, Diagnosis

  https://www.emedicinehealth.com/nephrotic_syndrome/article_em.htm

  It is possible to prevent nephrotic syndrome in some people, but not in others, depending on the treatability of underlying causes. […] It may be possible to prevent some types of the disease by stopping the underlying cause (prevention of kidney trauma, avoiding heroin use) while it’s impossible to prevent the other types (genetic cause). In general, if it’s possible to prevent the underlying cause, it’s possible to prevent the disease.

• #4 Nephrotic syndrome Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/nephrotic-syndrome

  Treating conditions that can cause nephrotic syndrome may help prevent the syndrome.

• #5 Childhood Nephrotic Syndrome – Causes, Risk Factors, Symptoms, Diagnosis, Treatment & Prevention

  https://www.medindia.net/health/conditions/childhood-nephrotic-syndrome.htm

  The only way to prevent nephrotic syndrome is to control the diseases that can cause kidney infection or damage. Upper respiratory tract infections are often triggers for relapse in children with frequent relapse of nephrotic syndrome and in such children, their doctor may prescribe a short course of steroids for 5-7 days during the infection to prevent relapse.

• #6 Overview of Nephrotic Syndrome – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/glomerular-disorders/overview-of-nephrotic-syndrome

  Management of infection risk […] All patients should receive pneumococcal vaccination if not otherwise contraindicated (1, 2, 3). […] […] Treatment of underlying disorders may include prompt treatment of infections (eg, staphylococcal endocarditis, malaria, syphilis, schistosomiasis), and stopping medications (eg, gold, penicillamine, nonsteroidal anti-inflammatory drugs [NSAIDs]); these measures may cure nephrotic syndrome in specific instances. […] […] Anticoagulants are indicated for treatment of thromboembolism, but few data exist to support their use as primary prevention.

• #7 Nephrotic Syndrome: Diet, Causes & Prevention| Medanta | Medanta

  https://www.medanta.org/patient-education-blog/nephrotic-syndrome-diet-causes-prevention-medanta

  Some causes of nephrotic syndrome cannot be prevented, but you can surely follow measures that can help prevent the damage caused to the glomeruli. Here is how you can prevent it: […] If you have diabetes or high blood pressure, make sure that you follow all means to gain control over your sugar and BP level. […] Also, ensure that you are vaccinated for all sorts of common infections, especially if you live or work in a surrounding where people are infected with hepatitis or other common diseases. […] If antibiotics are prescribed, do take them per the doctor’s direction and complete the medication course as per the prescription, even if you feel better.

• #8 Nephrotic Syndrome

  http://library.oumedicine.com/Search/85,P01486

  Not all causes of nephrotic syndrome can be prevented. To prevent damage to the glomeruli: […] Make sure your blood pressure is well controlled. […] If you have diabetes, make sure your blood sugar is controlled. […] Keep up-to-date with vaccines that help to prevent common infections. This is especially true if you work or live around people who have hepatitis and other viral infections. […] Finish all antibiotics as prescribed. Don’t stop your antibiotics because you may be feeling better. And dont save them for a later date.

• #9 Nephrotic Syndrome: Diet, Causes & Prevention| Medanta | Medanta

  https://www.medanta.org/patient-education-blog/nephrotic-syndrome-diet-causes-prevention-medanta

  Some causes of nephrotic syndrome cannot be prevented, but you can surely follow measures that can help prevent the damage caused to the glomeruli. Here is how you can prevent it: […] If you have diabetes or high blood pressure, make sure that you follow all means to gain control over your sugar and BP level. […] Also, ensure that you are vaccinated for all sorts of common infections, especially if you live or work in a surrounding where people are infected with hepatitis or other common diseases. […] If antibiotics are prescribed, do take them per the doctor’s direction and complete the medication course as per the prescription, even if you feel better.

• #10 Nephrotic Syndrome

  http://library.oumedicine.com/Search/85,P01486

  Not all causes of nephrotic syndrome can be prevented. To prevent damage to the glomeruli: […] Make sure your blood pressure is well controlled. […] If you have diabetes, make sure your blood sugar is controlled. […] Keep up-to-date with vaccines that help to prevent common infections. This is especially true if you work or live around people who have hepatitis and other viral infections. […] Finish all antibiotics as prescribed. Don’t stop your antibiotics because you may be feeling better. And dont save them for a later date.

• #11 Overview of Nephrotic Syndrome – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/glomerular-disorders/overview-of-nephrotic-syndrome

  Management of infection risk […] All patients should receive pneumococcal vaccination if not otherwise contraindicated (1, 2, 3). […] […] Treatment of underlying disorders may include prompt treatment of infections (eg, staphylococcal endocarditis, malaria, syphilis, schistosomiasis), and stopping medications (eg, gold, penicillamine, nonsteroidal anti-inflammatory drugs [NSAIDs]); these measures may cure nephrotic syndrome in specific instances. […] […] Anticoagulants are indicated for treatment of thromboembolism, but few data exist to support their use as primary prevention.

• #12 Nephrotic Syndrome – Kidney and Urinary Tract Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/kidney-filtering-disorders/nephrotic-syndrome

  Use of an angiotensin-converting enzyme (ACE) inhibitor, such as enalapril, benazepril, or lisinopril, or an angiotensin II receptor blocker (ARB), such as candesartan, losartan, or valsartan, is the mainstay of both prevention and treatment. […] When a person with a disease such as systemic lupus erythematosus or diabetes mellitus has mild or moderate proteinuria, an ACE inhibitor or ARB is used as soon as possible because the medication may prevent proteinuria from increasing and kidney function from worsening.

• #13 Anticoagulation for the Prevention of Thrombotic Events in Nephrotic Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11489394/

  Nephrotic syndrome (NS) predisposes to venous thromboembolic events with membranous nephropathy carrying the highest risk. Clinicians caring for patients with NS must balance the benefits of anticoagulation against potential harms, primarily bleeding. […] The decision to prescribe anticoagulants was based on clinical factors for 87% of respondents, including NS type, degree of hypoalbuminemia, and bleeding risk. […] The majority of respondents agreed that a randomized controlled trial is needed to address efficacy and safety of anticoagulation in NS. […] Our survey indicates hypoalbuminemia as an important factor guiding anticoagulation decisions, and this is consistent with the observed thrombotic risk with hypoalbuminemia demonstrated in large cohort studies. […] The efficacy and safety of DOACs in patients with NS remains clinically uncertain due to physiologic alterations that occur in NS.

• #14

  https://journals.lww.com/cjasn/fulltext/2020/01000/prophylactic_anticoagulation_in_adult_patients.19.aspx

  Increased thromboembolic risk is a well recognized complication of nephrotic syndrome, with variable reported incidence of deep venous thrombosis (approximately 15%), pulmonary embolus (10%30%) and renal vein thrombosis (25%37%) (1). […] Thromboembolic events are a preventable cause of morbidity and mortality in patients with nephrotic syndrome, yet prophylactic anticoagulation is not universally initiated. […] The 2012 Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline for GN suggested with low-quality evidence (level 2C) that anticoagulation should be considered in membranous nephropathy if serum albumin is 2.0 to 2.5 g/dl with additional risks for thrombosis (proteinuria, 10 g/d; body mass index, 35 kg/m2; family history of thromboembolism with documented genetic predisposition; New York Heart Association class III or IV congestive heart failure; recent abdominal or orthopedic surgery; or prolonged immobilization) (6).

• #15

  https://journals.lww.com/cjasn/fulltext/2020/01000/prophylactic_anticoagulation_in_adult_patients.19.aspx

  Increased thromboembolic risk is a well recognized complication of nephrotic syndrome, with variable reported incidence of deep venous thrombosis (approximately 15%), pulmonary embolus (10%30%) and renal vein thrombosis (25%37%) (1). […] Thromboembolic events are a preventable cause of morbidity and mortality in patients with nephrotic syndrome, yet prophylactic anticoagulation is not universally initiated. […] The 2012 Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline for GN suggested with low-quality evidence (level 2C) that anticoagulation should be considered in membranous nephropathy if serum albumin is 2.0 to 2.5 g/dl with additional risks for thrombosis (proteinuria, 10 g/d; body mass index, 35 kg/m2; family history of thromboembolism with documented genetic predisposition; New York Heart Association class III or IV congestive heart failure; recent abdominal or orthopedic surgery; or prolonged immobilization) (6).

• #16 Anticoagulation for the Prevention of Thrombotic Events in Nephrotic Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11489394/

  Nephrotic syndrome (NS) predisposes to venous thromboembolic events with membranous nephropathy carrying the highest risk. Clinicians caring for patients with NS must balance the benefits of anticoagulation against potential harms, primarily bleeding. […] The decision to prescribe anticoagulants was based on clinical factors for 87% of respondents, including NS type, degree of hypoalbuminemia, and bleeding risk. […] The majority of respondents agreed that a randomized controlled trial is needed to address efficacy and safety of anticoagulation in NS. […] Our survey indicates hypoalbuminemia as an important factor guiding anticoagulation decisions, and this is consistent with the observed thrombotic risk with hypoalbuminemia demonstrated in large cohort studies. […] The efficacy and safety of DOACs in patients with NS remains clinically uncertain due to physiologic alterations that occur in NS.

• #17

  https://journals.lww.com/cjasn/fulltext/2020/01000/prophylactic_anticoagulation_in_adult_patients.19.aspx

  To summarize, risks for arterial and venous thromboembolic events in nephrotic syndrome are increased with severe hypoalbuminemia and especially in patients with membranous nephropathy. If the risk of bleeding is perceived to be low, it would be reasonable to initiate prophylactic anticoagulation early in diagnosis for patients with membranous nephropathy who have serum albumin levels 2 to 2.5 g/dl. […] Further increased risk of venous thromboembolic events with immobility, obesity, malignancy, recent surgery, pregnancy, medications, central venous catheters, or genetic predisposition would decrease the threshold to start prophylaxis.

• #18

  https://journals.lww.com/cjasn/fulltext/2020/01000/prophylactic_anticoagulation_in_adult_patients.19.aspx

  Increased thromboembolic risk is a well recognized complication of nephrotic syndrome, with variable reported incidence of deep venous thrombosis (approximately 15%), pulmonary embolus (10%30%) and renal vein thrombosis (25%37%) (1). […] Thromboembolic events are a preventable cause of morbidity and mortality in patients with nephrotic syndrome, yet prophylactic anticoagulation is not universally initiated. […] The 2012 Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline for GN suggested with low-quality evidence (level 2C) that anticoagulation should be considered in membranous nephropathy if serum albumin is 2.0 to 2.5 g/dl with additional risks for thrombosis (proteinuria, 10 g/d; body mass index, 35 kg/m2; family history of thromboembolism with documented genetic predisposition; New York Heart Association class III or IV congestive heart failure; recent abdominal or orthopedic surgery; or prolonged immobilization) (6).

• #19 Management of congenital nephrotic syndrome: consensus recommendations of the ERKNet-ESPN Working Group | Nature Reviews Nephrology

  https://www.nature.com/articles/s41581-020-00384-1

  We do not suggest routinely administering antibiotic prophylaxis in children with CNS; however, prompt antibiotic treatment should be started in the case of a suspected bacterial infection. […] We recommend provision of a diet with a high energy (130kcal/kg/day) and protein (4g/kg/day) content but low salt content (0.53g/day depending on the age of the patient). […] We suggest that preventive anticoagulation should be considered in patients with CNS during states of increased thrombosis risk (owing to acute illness, risk of dehydration, inserted central lines and/or thrombocytosis 750,000/ml) and/or in patients with a previous thrombosis. […] We recommend following the vaccination schedule that is recommended for healthy children, including vaccinating against encapsulated bacteria and varicella-zoster virus (VZV), and administering the influenza vaccine annually. […] We recommend treatment of VZV infection with intravenous high-dose acyclovir for 710 days.

• #20 Diagnosis and Management of Nephrotic Syndrome in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0315/p479.html

  Routine prophylactic treatment to prevent infection or thrombosis is not recommended. […] Despite the known risk of venous thrombosis in patients with NS, there are no randomized controlled trials to guide whether prophylactic anticoagulation should be used and for how long. […] A Cochrane review found no strong evidence to recommend a specific intervention to prevent infection in adults with NS. […] Although the benefits of anticoagulation may outweigh the risks in selected patients at high risk of venous thrombosis, anticoagulation is not routinely used for primary prevention of thrombotic events in patients with NS. […] A recent Cochrane review found insufficient evidence to determine if lipid-lowering agents are helpful in managing dyslipidemia in adults with NS and no other indications for treatment based on previously obtained lipid levels.

• #21 Nephrotic Syndrome in Adults: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/1115/p1129.html

  Intravenous albumin, prophylactic antibiotics, and prophylactic anticoagulation are not currently recommended. […] There are currently no recommendations for prophylactic anticoagulation to prevent thromboembolic events in persons with nephrotic syndrome who have not had previous thrombotic events, and clinical practice varies. […] Given the uncertain risks of infection in adults with nephrotic syndrome in the United States, there are currently no indications for antibiotics or other interventions to prevent infection in this population.

• #22 Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study | Thrombosis Journal | Full Text

  https://thrombosisjournal.biomedcentral.com/articles/10.1186/s12959-025-00685-0

  Nephrotic syndrome (NS) is associated with an increased risk of venous thromboembolism (VTE). Anticoagulants are widely used in the prevention of VTE in NS patients. The aim of this study is to determine the efficacy and safety of DOACs compared to warfarin for prophylactic anticoagulation in patients with nephrotic syndrome. […] The decision to prescribe prophylactic anticoagulation in NS requires case by case assessment and depends on several factors which encompass underlying disease, severity of the NS (as assessed by serum albumin concentration), preexisting thrombotic event, and the risk of serious bleeding events consequent to oral anticoagulation. Recent guidelines for management of glomerular disorder showed that presence of histologic diagnosis of glomerular disease, degree of proteinuria, and serum albumin2.5 g/dL may predict VTE risk for those patients.

• #23 Nephrotic Syndrome: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.nephrotic-syndrome-care-instructions.abs1815

  Follow your doctor’s advice for the amounts of protein and potassium you need in your diet. […] Having nephrotic syndrome increases your risk for infections like peritonitis or respiratory and skin infections. Here are some tips to stay healthy: Wash your hands often, especially before eating and after being in public places. Avoid people who are sick. Use mild soaps, such as Dove or Cetaphil. Use moisturizing lotion after you bathe. You can use it more often if your skin is dry. Choose a lotion with no alcohol.

• #24 Overview of Nephrotic Syndrome – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/glomerular-disorders/overview-of-nephrotic-syndrome

  Management of infection risk […] All patients should receive pneumococcal vaccination if not otherwise contraindicated (1, 2, 3). […] […] Treatment of underlying disorders may include prompt treatment of infections (eg, staphylococcal endocarditis, malaria, syphilis, schistosomiasis), and stopping medications (eg, gold, penicillamine, nonsteroidal anti-inflammatory drugs [NSAIDs]); these measures may cure nephrotic syndrome in specific instances. […] […] Anticoagulants are indicated for treatment of thromboembolism, but few data exist to support their use as primary prevention.

• #25

  https://link.springer.com/article/10.1007/s00467-015-3241-0

  However, the existing data bring into question the efficacy of penicillin V in paediatric INS. […] It has been estimated that approximately 110 children with INS would need to be treated for 1 year to prevent one episode of pneumococcal infection. […] The risk of potential drug side-effects and the development of penicillin-resistant organisms must be balanced against the potential benefit of chemoprophylaxis for children with INS. […] The criteria for use of prophylactic antibiotics in children with INS have traditionally been an active area of debate. […] However, the topic has become less relevant following the introduction of universal pneumococcal vaccination. […] The AAP recommends the administration of pneumococcal vaccines to children with INS (if not already immunised). […] The IAP recommends two to four doses of the conjugate pneumococcal vaccine for children aged 2 years.

• #26 Nephrotic Syndrome Management

  https://pch.health.wa.gov.au/For-health-professionals/Clinical-Practice-Guidelines/Nephrotic-Syndrome-Management

  All children are recommended to receive the pneumococcal vaccine as part of the WA Immunisation Schedule at 2, 4 and 12 months of age with Prevenar13. Children with nephrotic syndrome require additional pneumococcal vaccines (given ideally at diagnosis) with the following: […] Annual influenza vaccination from 6 months of age is recommended. […] Patients and carers should commence education early in the admission and referrals made to the Renal Dietitian and the Renal CNS. An education plan must include: […] Each child will have an individualised Nephrotic Syndrome Relapse Treatment Plan that will outline the steroid and antibiotic dosing regimen and fluid restriction (plus medication for gastrointestinal protection if warranted).

• #27

  https://link.springer.com/article/10.1007/s00467-015-3241-0

  The AAP recommends annual seasonal administration of influenza vaccine to children with INS. […] The AAP recommends varicella vaccination for non-immune children with INS, post-exposure immunoglobulin for non-immune immunocompromised children and the consideration of intravenous acyclovir for immunocompromised children at the onset of varicella skin lesions. […] The IAP recommends that children who develop VZV infection should receive intravenous aciclovir (1500 mg/m2/day in 3 divided doses) or oral aciclovir (80 mg/kg/day in 4 divided doses) for 710 days. […] The IAP states that there is no role for prophylactic treatment with anticoagulants in children with INS (even during periods of hypoalbuminaemia and oedema). […] Guidelines from France acknowledge that no consensus regarding TED primary prophylaxis exists.

• #28

  https://link.springer.com/article/10.1007/s00467-015-3241-0

  The AAP recommends annual seasonal administration of influenza vaccine to children with INS. […] The AAP recommends varicella vaccination for non-immune children with INS, post-exposure immunoglobulin for non-immune immunocompromised children and the consideration of intravenous acyclovir for immunocompromised children at the onset of varicella skin lesions. […] The IAP recommends that children who develop VZV infection should receive intravenous aciclovir (1500 mg/m2/day in 3 divided doses) or oral aciclovir (80 mg/kg/day in 4 divided doses) for 710 days. […] The IAP states that there is no role for prophylactic treatment with anticoagulants in children with INS (even during periods of hypoalbuminaemia and oedema). […] Guidelines from France acknowledge that no consensus regarding TED primary prophylaxis exists.

• #29 Management of congenital nephrotic syndrome: consensus recommendations of the ERKNet-ESPN Working Group | Nature Reviews Nephrology

  https://www.nature.com/articles/s41581-020-00384-1

  We do not suggest routinely administering antibiotic prophylaxis in children with CNS; however, prompt antibiotic treatment should be started in the case of a suspected bacterial infection. […] We recommend provision of a diet with a high energy (130kcal/kg/day) and protein (4g/kg/day) content but low salt content (0.53g/day depending on the age of the patient). […] We suggest that preventive anticoagulation should be considered in patients with CNS during states of increased thrombosis risk (owing to acute illness, risk of dehydration, inserted central lines and/or thrombocytosis 750,000/ml) and/or in patients with a previous thrombosis. […] We recommend following the vaccination schedule that is recommended for healthy children, including vaccinating against encapsulated bacteria and varicella-zoster virus (VZV), and administering the influenza vaccine annually. […] We recommend treatment of VZV infection with intravenous high-dose acyclovir for 710 days.

• #30 Nephrotic Syndrome in Children

  https://healthinfo.coxhealth.com/library/Wellness/Prevention/90,P03098

  Help prevent your child from having contact with people who have colds or other respiratory illness. A viral respiratory illness could cause a relapse. […] Test your child’s urine for protein every day. This will help to find the early signs of a relapse. […] Postpone routine vaccines until your child is in remission and off steroids for at least 3 months. Talk with your child’s healthcare provider. […] The diet for a child with nephrotic syndrome may include limiting salt and fluids. This may help to regulate your child’s fluid balance. Fluids include any food that is liquid at room temperature, such as ice pops and ice cream. Salt affects body swelling. Don’t add salt at the table and don’t give your child salty foods. Your child’s healthcare provider will talk with you about how much salt and fluids your child should have each day.

• #31 Diagnosis and Management of Nephrotic Syndrome in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0315/p479.html

  Routine prophylactic treatment to prevent infection or thrombosis is not recommended. […] Despite the known risk of venous thrombosis in patients with NS, there are no randomized controlled trials to guide whether prophylactic anticoagulation should be used and for how long. […] A Cochrane review found no strong evidence to recommend a specific intervention to prevent infection in adults with NS. […] Although the benefits of anticoagulation may outweigh the risks in selected patients at high risk of venous thrombosis, anticoagulation is not routinely used for primary prevention of thrombotic events in patients with NS. […] A recent Cochrane review found insufficient evidence to determine if lipid-lowering agents are helpful in managing dyslipidemia in adults with NS and no other indications for treatment based on previously obtained lipid levels.

• #32 Nephrotic Syndrome in Adults: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/1115/p1129.html

  Intravenous albumin, prophylactic antibiotics, and prophylactic anticoagulation are not currently recommended. […] There are currently no recommendations for prophylactic anticoagulation to prevent thromboembolic events in persons with nephrotic syndrome who have not had previous thrombotic events, and clinical practice varies. […] Given the uncertain risks of infection in adults with nephrotic syndrome in the United States, there are currently no indications for antibiotics or other interventions to prevent infection in this population.

• #33

  https://link.springer.com/article/10.1007/s00467-015-3241-0

  Currently, it is not standard practice to routinely administer antibiotic prophylaxis in relapse or remission of INS. […] The AAP states that there are no data supporting the efficacy of prophylactic penicillin in preventing peritonitis in INS. […] French guidance recommends prescribing antibiotics only if infection is evident. […] However, some centres, including the Royal Manchester Childrens Hospital (UK) routinely prescribe penicillin prophylaxis (phenoxymethylpenicillin/penicillin V 12.5 mg/kg twice daily) during relapse and stop antibiotic therapy when oedema has abated. […] The reason for the marked variation in clinical practice may be explained by the lack of data: no randomised controlled trial (RCT) has ever been performed to test the efficacy of antibiotic prophylaxis in INS.

• #34

  https://link.springer.com/article/10.1007/s00467-015-3241-0

  Currently, it is not standard practice to routinely administer antibiotic prophylaxis in relapse or remission of INS. […] The AAP states that there are no data supporting the efficacy of prophylactic penicillin in preventing peritonitis in INS. […] French guidance recommends prescribing antibiotics only if infection is evident. […] However, some centres, including the Royal Manchester Childrens Hospital (UK) routinely prescribe penicillin prophylaxis (phenoxymethylpenicillin/penicillin V 12.5 mg/kg twice daily) during relapse and stop antibiotic therapy when oedema has abated. […] The reason for the marked variation in clinical practice may be explained by the lack of data: no randomised controlled trial (RCT) has ever been performed to test the efficacy of antibiotic prophylaxis in INS.

• #35

  https://link.springer.com/article/10.1007/s00467-015-3241-0

  Currently, it is not standard practice to routinely administer antibiotic prophylaxis in relapse or remission of INS. […] The AAP states that there are no data supporting the efficacy of prophylactic penicillin in preventing peritonitis in INS. […] French guidance recommends prescribing antibiotics only if infection is evident. […] However, some centres, including the Royal Manchester Childrens Hospital (UK) routinely prescribe penicillin prophylaxis (phenoxymethylpenicillin/penicillin V 12.5 mg/kg twice daily) during relapse and stop antibiotic therapy when oedema has abated. […] The reason for the marked variation in clinical practice may be explained by the lack of data: no randomised controlled trial (RCT) has ever been performed to test the efficacy of antibiotic prophylaxis in INS.

• #36 No strong evidence for any interventions for preventing infection in nephrotic syndrome | Cochrane

  https://www.cochrane.org/CD003964/RENAL_no-strong-evidence-for-any-interventions-for-preventing-infection-in-nephrotic-syndrome

  No strong evidence for any interventions for preventing infection in nephrotic syndrome. […] Currently there is no strong evidence for recommending any interventions for preventing infections in nephrotic syndrome. […] However the methodological quality of all studies was poor, the sample sizes small, and all studies were from China, and thus there is no strong evidence on the effectiveness of these interventions. […] Many different prophylactic interventions have been used or recommended for reducing the risks of infection in nephrotic syndrome in clinical practice. […] Whether the existing evidence is scientifically rigorous and which prophylactic intervention can be recommended for routine use based on the current evidence is still unknown. […] No studies were identified in adults. […] No RCTs were identified comparing antibiotics, non-pharmacological prophylaxis, or pneumococcal vaccination. […] No serious adverse events were reported.

• #37 Management of congenital nephrotic syndrome: consensus recommendations of the ERKNet-ESPN Working Group | Nature Reviews Nephrology

  https://www.nature.com/articles/s41581-020-00384-1

  We do not suggest routinely administering antibiotic prophylaxis in children with CNS; however, prompt antibiotic treatment should be started in the case of a suspected bacterial infection. […] We recommend provision of a diet with a high energy (130kcal/kg/day) and protein (4g/kg/day) content but low salt content (0.53g/day depending on the age of the patient). […] We suggest that preventive anticoagulation should be considered in patients with CNS during states of increased thrombosis risk (owing to acute illness, risk of dehydration, inserted central lines and/or thrombocytosis 750,000/ml) and/or in patients with a previous thrombosis. […] We recommend following the vaccination schedule that is recommended for healthy children, including vaccinating against encapsulated bacteria and varicella-zoster virus (VZV), and administering the influenza vaccine annually. […] We recommend treatment of VZV infection with intravenous high-dose acyclovir for 710 days.

• #38 Nephrotic Syndrome: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.nephrotic-syndrome-care-instructions.abs1815

  Follow your doctor’s advice for the amounts of protein and potassium you need in your diet. […] Having nephrotic syndrome increases your risk for infections like peritonitis or respiratory and skin infections. Here are some tips to stay healthy: Wash your hands often, especially before eating and after being in public places. Avoid people who are sick. Use mild soaps, such as Dove or Cetaphil. Use moisturizing lotion after you bathe. You can use it more often if your skin is dry. Choose a lotion with no alcohol.

• #39 Nephrotic Syndrome | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.nephrotic-syndrome.aa124982

  Treatment aims to reverse, slow, or prevent further kidney damage. […] Having nephrotic syndrome increases your risk for infections like peritonitis or respiratory and skin infections. Here are some tips to stay healthy: Wash your hands often, especially before eating and after being in public places. […] Cut down on salt. This can reduce the amount of water your body retains. […] Follow your doctor’s advice for the amounts of protein and potassium you need in your diet.

• #40 Nephrotic Syndrome: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.nephrotic-syndrome-care-instructions.abs1815

  Follow your doctor’s advice for the amounts of protein and potassium you need in your diet. […] Having nephrotic syndrome increases your risk for infections like peritonitis or respiratory and skin infections. Here are some tips to stay healthy: Wash your hands often, especially before eating and after being in public places. Avoid people who are sick. Use mild soaps, such as Dove or Cetaphil. Use moisturizing lotion after you bathe. You can use it more often if your skin is dry. Choose a lotion with no alcohol.

• #41 Nephrotic Syndrome in Children

  https://healthinfo.coxhealth.com/library/Wellness/Prevention/90,P03098

  Help prevent your child from having contact with people who have colds or other respiratory illness. A viral respiratory illness could cause a relapse. […] Test your child’s urine for protein every day. This will help to find the early signs of a relapse. […] Postpone routine vaccines until your child is in remission and off steroids for at least 3 months. Talk with your child’s healthcare provider. […] The diet for a child with nephrotic syndrome may include limiting salt and fluids. This may help to regulate your child’s fluid balance. Fluids include any food that is liquid at room temperature, such as ice pops and ice cream. Salt affects body swelling. Don’t add salt at the table and don’t give your child salty foods. Your child’s healthcare provider will talk with you about how much salt and fluids your child should have each day.

• #42 Nephrotic Syndrome: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.nephrotic-syndrome-care-instructions.abs1815

  Follow your doctor’s advice for the amounts of protein and potassium you need in your diet. […] Having nephrotic syndrome increases your risk for infections like peritonitis or respiratory and skin infections. Here are some tips to stay healthy: Wash your hands often, especially before eating and after being in public places. Avoid people who are sick. Use mild soaps, such as Dove or Cetaphil. Use moisturizing lotion after you bathe. You can use it more often if your skin is dry. Choose a lotion with no alcohol.

• #43

  https://www.kidneyeducation.com/english/nephrotic-syndrome/22

  Infection is an important cause of recurrence of nephrotic syndrome, so it is essential to protect children against infection. […] Prevention, early detection and treatment of infection are essential in nephrotic syndrome because infection can lead to a relapse of controlled disease (even when the patient is receiving treatment). […] To prevent infection, the family and child should be trained to drink clean water, wash hands thoroughly and avoid crowded areas or contact with infectious patients. […] Routine immunization is advised when steroid course is completed.

• #44 Nephrotic syndrome diet: Foods to eat and avoid

  https://www.medicalnewstoday.com/articles/nephrotic-syndrome-diet

  A nephrotic syndrome diet can help people with nephrotic syndrome. Eating some foods and avoiding others may help a person to improve or manage symptoms. […] Scientists do not believe diet and nutrition play a part in causing or preventing nephrotic syndrome. However, a persons diet can affect their symptoms. […] Doctors may recommend people with nephrotic syndrome: reduce the amount of salt in their diet to help control symptoms such as: fluid retention, edema, or swelling, resulting from fluid trapped in a persons body tissues, high blood pressure. […] Doctors generally recommend that people with nephrotic syndrome follow a low-sodium or low-salt diet. This can help to manage blood pressure and fluid retention. […] A doctor may recommend that a person consumes a diet rich in whole grains, fruits, and vegetables. It is generally best for a person to avoid foods high in salt or sodium. Although nephrotic syndrome is due to the loss of protein in urine, doctors do not typically recommend a diet high in protein. […] A dietitian or nutritionist can help a person to create a suitable eating plan. This will help them to manage their symptoms while ensuring they get enough essential nutrients.

• #45 Nephrotic Syndrome Diet: Restrictions and Foods You Can Eat

  https://www.healthline.com/health/nephrotic-syndrome-diet

  Nephrotic syndrome cannot be prevented, but treating an underlying kidney disease and making dietary changes may prevent worsening of symptoms. […] Treatment options may include blood pressure medication, diuretics, blood thinners, cholesterol-reducing medication, or a steroid if kidney disease causes inflammation. […] Your doctor may also refer you to a dietitian, an expert on diet and nutrition.

• #46 Nephrotic syndrome diet: Foods to eat and avoid

  https://www.medicalnewstoday.com/articles/nephrotic-syndrome-diet

  A nephrotic syndrome diet can help people with nephrotic syndrome. Eating some foods and avoiding others may help a person to improve or manage symptoms. […] Scientists do not believe diet and nutrition play a part in causing or preventing nephrotic syndrome. However, a persons diet can affect their symptoms. […] Doctors may recommend people with nephrotic syndrome: reduce the amount of salt in their diet to help control symptoms such as: fluid retention, edema, or swelling, resulting from fluid trapped in a persons body tissues, high blood pressure. […] Doctors generally recommend that people with nephrotic syndrome follow a low-sodium or low-salt diet. This can help to manage blood pressure and fluid retention. […] A doctor may recommend that a person consumes a diet rich in whole grains, fruits, and vegetables. It is generally best for a person to avoid foods high in salt or sodium. Although nephrotic syndrome is due to the loss of protein in urine, doctors do not typically recommend a diet high in protein. […] A dietitian or nutritionist can help a person to create a suitable eating plan. This will help them to manage their symptoms while ensuring they get enough essential nutrients.

• #47

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/nephrotic-syndrome-in-children.aspx

  A low salt (sodium) diet to help limit the swelling in the body is often recommended for children with nephrotic syndrome. […] This is most important when there is protein leaking into the urine.

• #48 Nephrotic syndrome diet: Foods to eat and avoid

  https://www.medicalnewstoday.com/articles/nephrotic-syndrome-diet

  A nephrotic syndrome diet can help people with nephrotic syndrome. Eating some foods and avoiding others may help a person to improve or manage symptoms. […] Scientists do not believe diet and nutrition play a part in causing or preventing nephrotic syndrome. However, a persons diet can affect their symptoms. […] Doctors may recommend people with nephrotic syndrome: reduce the amount of salt in their diet to help control symptoms such as: fluid retention, edema, or swelling, resulting from fluid trapped in a persons body tissues, high blood pressure. […] Doctors generally recommend that people with nephrotic syndrome follow a low-sodium or low-salt diet. This can help to manage blood pressure and fluid retention. […] A doctor may recommend that a person consumes a diet rich in whole grains, fruits, and vegetables. It is generally best for a person to avoid foods high in salt or sodium. Although nephrotic syndrome is due to the loss of protein in urine, doctors do not typically recommend a diet high in protein. […] A dietitian or nutritionist can help a person to create a suitable eating plan. This will help them to manage their symptoms while ensuring they get enough essential nutrients.

• #49 Nephrotic Syndrome | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.nephrotic-syndrome.aa124982

  Treatment aims to reverse, slow, or prevent further kidney damage. […] Having nephrotic syndrome increases your risk for infections like peritonitis or respiratory and skin infections. Here are some tips to stay healthy: Wash your hands often, especially before eating and after being in public places. […] Cut down on salt. This can reduce the amount of water your body retains. […] Follow your doctor’s advice for the amounts of protein and potassium you need in your diet.

• #50 Nephrotic syndrome diet: Foods to eat and avoid

  https://www.medicalnewstoday.com/articles/nephrotic-syndrome-diet

  A nephrotic syndrome diet can help people with nephrotic syndrome. Eating some foods and avoiding others may help a person to improve or manage symptoms. […] Scientists do not believe diet and nutrition play a part in causing or preventing nephrotic syndrome. However, a persons diet can affect their symptoms. […] Doctors may recommend people with nephrotic syndrome: reduce the amount of salt in their diet to help control symptoms such as: fluid retention, edema, or swelling, resulting from fluid trapped in a persons body tissues, high blood pressure. […] Doctors generally recommend that people with nephrotic syndrome follow a low-sodium or low-salt diet. This can help to manage blood pressure and fluid retention. […] A doctor may recommend that a person consumes a diet rich in whole grains, fruits, and vegetables. It is generally best for a person to avoid foods high in salt or sodium. Although nephrotic syndrome is due to the loss of protein in urine, doctors do not typically recommend a diet high in protein. […] A dietitian or nutritionist can help a person to create a suitable eating plan. This will help them to manage their symptoms while ensuring they get enough essential nutrients.

• #51 Management of congenital nephrotic syndrome: consensus recommendations of the ERKNet-ESPN Working Group | Nature Reviews Nephrology

  https://www.nature.com/articles/s41581-020-00384-1

  We do not suggest routinely administering antibiotic prophylaxis in children with CNS; however, prompt antibiotic treatment should be started in the case of a suspected bacterial infection. […] We recommend provision of a diet with a high energy (130kcal/kg/day) and protein (4g/kg/day) content but low salt content (0.53g/day depending on the age of the patient). […] We suggest that preventive anticoagulation should be considered in patients with CNS during states of increased thrombosis risk (owing to acute illness, risk of dehydration, inserted central lines and/or thrombocytosis 750,000/ml) and/or in patients with a previous thrombosis. […] We recommend following the vaccination schedule that is recommended for healthy children, including vaccinating against encapsulated bacteria and varicella-zoster virus (VZV), and administering the influenza vaccine annually. […] We recommend treatment of VZV infection with intravenous high-dose acyclovir for 710 days.

• #52 Nephrotic Syndrome in Children

  https://healthinfo.coxhealth.com/library/Wellness/Prevention/90,P03098

  Help prevent your child from having contact with people who have colds or other respiratory illness. A viral respiratory illness could cause a relapse. […] Test your child’s urine for protein every day. This will help to find the early signs of a relapse. […] Postpone routine vaccines until your child is in remission and off steroids for at least 3 months. Talk with your child’s healthcare provider. […] The diet for a child with nephrotic syndrome may include limiting salt and fluids. This may help to regulate your child’s fluid balance. Fluids include any food that is liquid at room temperature, such as ice pops and ice cream. Salt affects body swelling. Don’t add salt at the table and don’t give your child salty foods. Your child’s healthcare provider will talk with you about how much salt and fluids your child should have each day.

• #53 Nephrotic Syndrome Management

  https://pch.health.wa.gov.au/For-health-professionals/Clinical-Practice-Guidelines/Nephrotic-Syndrome-Management

  Standard treatment regimen at first presentation is an 8 week course of corticosteroids (prednisolone), prophylactic oral antibiotics and vaccination. […] Children, who are planned for or on significant immunosuppressive doses of corticosteroids (2 mg/kg/day of the prednisolone equivalent dose for greater than 1 week), require additional pneumococcal vaccines and annual influenza vaccination. […] Due to the likelihood of relapse, it is important during the first admission to initiate a child / carer education plan that includes recognising the signs / symptoms of relapse and home monitoring of proteinuria. […] All children being treated in the inpatient wards or in DTU should be referred to the Renal Clinical Nurse Specialist (CNS) so that education can be coordinated and an individualised home relapse treatment plan formulated.

• #54 Nephrotic Syndrome Management

  https://pch.health.wa.gov.au/For-health-professionals/Clinical-Practice-Guidelines/Nephrotic-Syndrome-Management

  Standard treatment regimen at first presentation is an 8 week course of corticosteroids (prednisolone), prophylactic oral antibiotics and vaccination. […] Children, who are planned for or on significant immunosuppressive doses of corticosteroids (2 mg/kg/day of the prednisolone equivalent dose for greater than 1 week), require additional pneumococcal vaccines and annual influenza vaccination. […] Due to the likelihood of relapse, it is important during the first admission to initiate a child / carer education plan that includes recognising the signs / symptoms of relapse and home monitoring of proteinuria. […] All children being treated in the inpatient wards or in DTU should be referred to the Renal Clinical Nurse Specialist (CNS) so that education can be coordinated and an individualised home relapse treatment plan formulated.

• #55 Nephrotic syndrome

  https://www.aboutkidshealth.ca/nephrotic-syndrome

  Prevention of complications […] – Always give medication as directed by your health-care provider. […] – It is important to regularly monitor your child’s urine. […] – Adhering to a low-salt diet during a relapse also helps control symptoms.

• #56 Nephrotic Syndrome in Children

  https://healthinfo.coxhealth.com/library/Wellness/Prevention/90,P03098

  Help prevent your child from having contact with people who have colds or other respiratory illness. A viral respiratory illness could cause a relapse. […] Test your child’s urine for protein every day. This will help to find the early signs of a relapse. […] Postpone routine vaccines until your child is in remission and off steroids for at least 3 months. Talk with your child’s healthcare provider. […] The diet for a child with nephrotic syndrome may include limiting salt and fluids. This may help to regulate your child’s fluid balance. Fluids include any food that is liquid at room temperature, such as ice pops and ice cream. Salt affects body swelling. Don’t add salt at the table and don’t give your child salty foods. Your child’s healthcare provider will talk with you about how much salt and fluids your child should have each day.

• #57 Nephrotic syndrome

  https://www.aboutkidshealth.ca/nephrotic-syndrome

  Prevention of complications […] – Always give medication as directed by your health-care provider. […] – It is important to regularly monitor your child’s urine. […] – Adhering to a low-salt diet during a relapse also helps control symptoms.

• #58 Nephrotic syndrome

  https://www.aboutkidshealth.ca/nephrotic-syndrome

  Prevention of complications […] – Always give medication as directed by your health-care provider. […] – It is important to regularly monitor your child’s urine. […] – Adhering to a low-salt diet during a relapse also helps control symptoms.

• #59 Nephrotic Syndrome Management

  https://pch.health.wa.gov.au/For-health-professionals/Clinical-Practice-Guidelines/Nephrotic-Syndrome-Management

  All children are recommended to receive the pneumococcal vaccine as part of the WA Immunisation Schedule at 2, 4 and 12 months of age with Prevenar13. Children with nephrotic syndrome require additional pneumococcal vaccines (given ideally at diagnosis) with the following: […] Annual influenza vaccination from 6 months of age is recommended. […] Patients and carers should commence education early in the admission and referrals made to the Renal Dietitian and the Renal CNS. An education plan must include: […] Each child will have an individualised Nephrotic Syndrome Relapse Treatment Plan that will outline the steroid and antibiotic dosing regimen and fluid restriction (plus medication for gastrointestinal protection if warranted).

• #60 Nephrotic Syndrome: Diet, Causes & Prevention| Medanta | Medanta

  https://www.medanta.org/patient-education-blog/nephrotic-syndrome-diet-causes-prevention-medanta

  Some causes of nephrotic syndrome cannot be prevented, but you can surely follow measures that can help prevent the damage caused to the glomeruli. Here is how you can prevent it: […] If you have diabetes or high blood pressure, make sure that you follow all means to gain control over your sugar and BP level. […] Also, ensure that you are vaccinated for all sorts of common infections, especially if you live or work in a surrounding where people are infected with hepatitis or other common diseases. […] If antibiotics are prescribed, do take them per the doctor’s direction and complete the medication course as per the prescription, even if you feel better.

• #61 Nephrotic Syndrome

  http://library.oumedicine.com/Search/85,P01486

  Not all causes of nephrotic syndrome can be prevented. To prevent damage to the glomeruli: […] Make sure your blood pressure is well controlled. […] If you have diabetes, make sure your blood sugar is controlled. […] Keep up-to-date with vaccines that help to prevent common infections. This is especially true if you work or live around people who have hepatitis and other viral infections. […] Finish all antibiotics as prescribed. Don’t stop your antibiotics because you may be feeling better. And dont save them for a later date.

• #62 Understanding Nephrotic Syndrome: Causes, Symptoms, Diagnosis & Treatment

  https://www.yashodahospitals.com/blog/nephrotic-syndrome-types-causes-diagnosis-treatment/

  Preventing nephrotic syndrome isnt always successful, particularly if its inherited, but controlling some risk factors can reduce the likelihood of developing it: […] Control diabetes: Tight control of blood sugar prevents diabetic nephropathy, one of the most common causes. […] Manage blood pressure: Maintaining healthy blood pressure keeps kidneys functioning well. […] Healthy weight: Excess weight can put a burden on the kidneys, making kidney disease more likely. […] Eat a balanced diet: A low-sodium, moderate-protein diet maintains healthy kidneys. […] Keep alcohol use under control: Alcohol abuse can destroy the kidneys. […] Avoid NSAIDs: Frequent use of anti-inflammatory drugs like ibuprofen and naproxen can ruin the kidneys. […] Infections getting treated early: Rapid response and treatment for infections can minimize the kidneys impact. […] Use medications cautiously: Talk with the doctor about possible kidney damage from medications. […] Stay hydrated: Staying well-hydrated helps maintain kidney function and general health.

• #63 Understanding Nephrotic Syndrome: Causes, Symptoms, Diagnosis & Treatment

  https://www.yashodahospitals.com/blog/nephrotic-syndrome-types-causes-diagnosis-treatment/

  Preventing nephrotic syndrome isnt always successful, particularly if its inherited, but controlling some risk factors can reduce the likelihood of developing it: […] Control diabetes: Tight control of blood sugar prevents diabetic nephropathy, one of the most common causes. […] Manage blood pressure: Maintaining healthy blood pressure keeps kidneys functioning well. […] Healthy weight: Excess weight can put a burden on the kidneys, making kidney disease more likely. […] Eat a balanced diet: A low-sodium, moderate-protein diet maintains healthy kidneys. […] Keep alcohol use under control: Alcohol abuse can destroy the kidneys. […] Avoid NSAIDs: Frequent use of anti-inflammatory drugs like ibuprofen and naproxen can ruin the kidneys. […] Infections getting treated early: Rapid response and treatment for infections can minimize the kidneys impact. […] Use medications cautiously: Talk with the doctor about possible kidney damage from medications. […] Stay hydrated: Staying well-hydrated helps maintain kidney function and general health.

• #64 Understanding Nephrotic Syndrome: Causes, Symptoms, Diagnosis & Treatment

  https://www.yashodahospitals.com/blog/nephrotic-syndrome-types-causes-diagnosis-treatment/

  Preventing nephrotic syndrome isnt always successful, particularly if its inherited, but controlling some risk factors can reduce the likelihood of developing it: […] Control diabetes: Tight control of blood sugar prevents diabetic nephropathy, one of the most common causes. […] Manage blood pressure: Maintaining healthy blood pressure keeps kidneys functioning well. […] Healthy weight: Excess weight can put a burden on the kidneys, making kidney disease more likely. […] Eat a balanced diet: A low-sodium, moderate-protein diet maintains healthy kidneys. […] Keep alcohol use under control: Alcohol abuse can destroy the kidneys. […] Avoid NSAIDs: Frequent use of anti-inflammatory drugs like ibuprofen and naproxen can ruin the kidneys. […] Infections getting treated early: Rapid response and treatment for infections can minimize the kidneys impact. […] Use medications cautiously: Talk with the doctor about possible kidney damage from medications. […] Stay hydrated: Staying well-hydrated helps maintain kidney function and general health.

• #65 Understanding Nephrotic Syndrome: Causes, Symptoms, Diagnosis & Treatment

  https://www.yashodahospitals.com/blog/nephrotic-syndrome-types-causes-diagnosis-treatment/

  Preventing nephrotic syndrome isnt always successful, particularly if its inherited, but controlling some risk factors can reduce the likelihood of developing it: […] Control diabetes: Tight control of blood sugar prevents diabetic nephropathy, one of the most common causes. […] Manage blood pressure: Maintaining healthy blood pressure keeps kidneys functioning well. […] Healthy weight: Excess weight can put a burden on the kidneys, making kidney disease more likely. […] Eat a balanced diet: A low-sodium, moderate-protein diet maintains healthy kidneys. […] Keep alcohol use under control: Alcohol abuse can destroy the kidneys. […] Avoid NSAIDs: Frequent use of anti-inflammatory drugs like ibuprofen and naproxen can ruin the kidneys. […] Infections getting treated early: Rapid response and treatment for infections can minimize the kidneys impact. […] Use medications cautiously: Talk with the doctor about possible kidney damage from medications. […] Stay hydrated: Staying well-hydrated helps maintain kidney function and general health.

• #66

  https://link.springer.com/article/10.1007/s00467-015-3241-0

  However, they suggest that children with a more severe disease phenotype may be considered for prophylaxis with aspirin or low molecular weight heparin (LMWH). […] The AAP recommends that during periods of disease activity and increased thromboembolic risk, children should be encouraged to continue physical activity and avoid prolonged bed rest.

• #67 Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study | Thrombosis Journal | Full Text

  https://thrombosisjournal.biomedcentral.com/articles/10.1186/s12959-025-00685-0

  The decision to commence prophylactic anticoagulation in NS remains uncertain and necessitates individualized assessment. Recent guidelines on the management of glomerular disorders have advocated for the initiation of prophylactic anticoagulant in patients with risk factors for VTE. This recommendation stems from several studies demonstrating that in patients with NS, prophylactic anticoagulation is associated with a decreased risk of clinically significant thromboembolism. […] This investigation helps address this gap by specifically examining the effectiveness and safety of DOACs in the prophylaxis of VTE in patients with NS.

• #68 What Is Secondary Nephrotic Syndrome?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/secondary-nephrotic-syndrome

  How To Prevent Secondary Nephrotic Syndrome? […] Diet Management – Dietary changes should be made by limiting the intake of sodium and fluids to control swelling. Reduction in the amount of cholesterol in the diet can help to control blood cholesterol levels. Weight management to control obesity. […] Management of Hypertension – Medications should be taken to control high blood pressure. Routine examination and a healthy diet should be maintained. Diabetes mellitus is the major cause of the secondary nephrotic syndrome, and it should be well maintained using hypoglycemics. […] Vaccination against infectious diseases like hepatitis should be taken. Antibiotics should be taken as and when prescribed by the physician. Once the underlying disease is treated, nephrotic syndrome can be treated easily. […] Maintaining a dietary habit of low sodium intake can help prevent swelling. Vaccination against opportunistic infections can help prevent infection. […] Cholesterol levels should be maintained by patients by changing dietary habits.

• #69 Understanding Nephrotic Syndrome: Causes, Symptoms, Diagnosis & Treatment

  https://www.yashodahospitals.com/blog/nephrotic-syndrome-types-causes-diagnosis-treatment/

  Preventing nephrotic syndrome isnt always successful, particularly if its inherited, but controlling some risk factors can reduce the likelihood of developing it: […] Control diabetes: Tight control of blood sugar prevents diabetic nephropathy, one of the most common causes. […] Manage blood pressure: Maintaining healthy blood pressure keeps kidneys functioning well. […] Healthy weight: Excess weight can put a burden on the kidneys, making kidney disease more likely. […] Eat a balanced diet: A low-sodium, moderate-protein diet maintains healthy kidneys. […] Keep alcohol use under control: Alcohol abuse can destroy the kidneys. […] Avoid NSAIDs: Frequent use of anti-inflammatory drugs like ibuprofen and naproxen can ruin the kidneys. […] Infections getting treated early: Rapid response and treatment for infections can minimize the kidneys impact. […] Use medications cautiously: Talk with the doctor about possible kidney damage from medications. […] Stay hydrated: Staying well-hydrated helps maintain kidney function and general health.

• #70 Nephrotic Syndrome: Symptoms, Causes, Therapy and Treatment

  https://www.metropolisindia.com/blog/preventive-healthcare/all-you-need-to-know-about-nephrotic-syndrome

  You cannot prevent specific nephrotic syndrome causes, but you can take steps to safeguard your glomeruli: […] Manage high blood pressure and diabetes, if applicable. […] Ensure you receive vaccinations for common infections, such as influenza, pneumonia, etc, especially if you are in close contact with individuals with hepatitis. […] If your doctor prescribes antibiotics, take them as directed and complete the entire prescription, even if symptoms improve.

• #71 Anticoagulation for the Prevention of Thrombotic Events in Nephrotic Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11489394/

  A randomized controlled trial examining thrombosis prevention in NS is fraught with many challenges. […] Clinical factors, particularly severity of hypoalbuminemia, play a major role in nephrologists decisions to offer anticoagulation for thromboprophylaxis in NS. […] Although a randomized controlled trial to examine safety and efficacy of thromboprophylaxis in NS would be beneficial, conducting this would likely require a large, multicenter, international, concerted effort and remain challenging to power sufficiently.

• #72 Diagnosis and Management of Nephrotic Syndrome in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0315/p479.html

  Routine prophylactic treatment to prevent infection or thrombosis is not recommended. […] Despite the known risk of venous thrombosis in patients with NS, there are no randomized controlled trials to guide whether prophylactic anticoagulation should be used and for how long. […] A Cochrane review found no strong evidence to recommend a specific intervention to prevent infection in adults with NS. […] Although the benefits of anticoagulation may outweigh the risks in selected patients at high risk of venous thrombosis, anticoagulation is not routinely used for primary prevention of thrombotic events in patients with NS. […] A recent Cochrane review found insufficient evidence to determine if lipid-lowering agents are helpful in managing dyslipidemia in adults with NS and no other indications for treatment based on previously obtained lipid levels.

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