What is the first line treatment for nephrotic syndrome?
Corticosteroids are generally considered the first agent used in an attempt to reduce proteinuria in all patients with nephrotic syndrome caused by MCNS or FSGS, unless there is a clinical contraindication to their use.
The dose and duration of therapy is highly contingent on the age of the patient, and the likelihood of response varies from greater than 90% in children with MCNS to less than 20% to 30% in patients with FSGS.
In patients with MN, current recommendations suggest using conservative therapy with agents that block the renin–angiotensin axis, and resorting to corticosteroids if the proteinuria does improve or if the patients are symptomatic.
The therapy of MPGN and the role of corticosteroids is determined by the specific disease subtype.
