Angiotensin converting enzyme inhibitors are used to reduce urinary protein, and captopril is commonly used 6.25 ~ 25mg daily, three times a day.
(2) Immunosuppression and inflammation treatment: ① Glucocorticoid: the initial dose should be sufficient, such as 40 ~ 60mg of prednisone daily for 8 ~ 12 weeks; Drug withdrawal should be slow, and the effective cases should reduce the original dose of10% every 2 ~ 3 weeks; The drug needs to be maintained for a long time, and the minimum effective dose (daily 10 ~ 15 mg) should be maintained for six months to one year or more. When the effect of prednisone is not good, prednisolone can be used instead.
② Cytotoxic drugs: cyclophosphamide (2mg/kg body weight per day, taken orally 1 ~ 2 times, or 200mg by intravenous injection every other day), which is accumulated to 6 ~ 8g and then stopped; Nitrogen mustard hydrochloride can be used when it is ineffective, but it has great side effects and should be used with caution.
③ Cyclosporine A: used for refractory nephrotic syndrome, 5mg/kg per day, taken orally twice, gradually reduced after 2-3 months, and taken for about half a year. Choosing appropriate drugs according to the pathological types of glomerular diseases can improve the curative effect.
(3) Treatment of complications: ① Infection: Use sensitive, potent and non-nephrotoxic antibiotics.
② Thromboembolism: anticoagulant was given when blood was hypercoagulable, heparin 12.5 ~ 25mg was injected subcutaneously, or warfarin and dipyridamole were taken orally. If there is thrombosis and embolism, urokinase or streptokinase should be used for thrombolysis, and anticoagulant should be used.
③ Acute renal failure: hemodialysis, active treatment of the primary disease, to prevent the deterioration of the disease.
④ protein and fat metabolism disorder: lipid-lowering drugs lovastatin and pravastatin, both 20mg, twice a day; Angiotensin converting enzyme inhibitor, etc.