In addition to addressing the underlying cause, treatment of nephrotic syndrome focuses on reducing high cholesterol, blood pressure, and protein in urine through diet, medications, or both. Two groups of blood pressure medications—angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)—also protect the kidneys by reducing proteinuria.
Some people may benefit from limiting protein in their diet to reduce the buildup of wastes in the blood.
Nephrotic syndrome may go away once the underlying cause, if known, has been treated. In children, 80 percent of cases of nephrotic syndrome are caused by a condition called minimal change disease, which can be successfully treated with prednisone. However, in adults, most of the time the underlying cause is a kidney disease such as membranous nephropathy or focal segmental glomerulonephritis, diseases that are treated with corticosteroids, immunosuppressive drugs, and, in some cases, cytotoxic agents. Unfortunately, these treatments do not always bring about remission of nephrotic syndrome. Depending on the disease, as many as half of the patients may develop chronic kidney disease that progresses to end-stage renal disease. In these cases, the kidneys gradually lose their ability to filter wastes and excess water from the blood. If kidney failure occurs, the person will need dialysis or a kidney transplant.