Kidney

Nephrotic Syndrome

By Gory ⋅ December 21, 2008 ⋅  Print This Post ⋅ Post a comment

So it’s all related:

• Proteinuria (蛋白尿)
• Less albumin (白蛋白) in the blood
• Edema due to reduced oncotic pressure within the blood vessels
• Hyperlipidemia – related to reduced albumin

The key issue here is that the protein is leaking out, causing the other problems.

Conventional Treatment

Treatment involves using middle to long term corticosteroids. The usual course of treatment is 6 months. Only 2 weeks after proteinuria shows negative do you begin lowering the dosage. E.g. you start taking prednisone (法尼松) 1.5-2mg/kg (max 60mg) until proteinuria tests negative. Continue for two weeks, then begin popping the pills only on alternate days for one month,  then start reducing overall dosage by 2.5-5mg.

The complications from Nephrotic Syndrome include edema and hypertension, which can be treated using diuretics or blood pressure lowering drugs.

Chinese Medicine as treatment

From 1978 onward, reports from the Military Hospital in Nanjing (南京军区总医院) confirmed that the herb Tripterygium Wilfordii (雷公藤) can be used to treat Nephrotic Syndrome. Search the web and you’ll find alot of information on this. In any case, It is able to reduce proteinuria, but not have the side effects of steroid use – see Cushing’s Syndrome. However it does have it’s own shortcomings. The list begins:

1. WBC levels fall
2. Also compromises liver and kidney function
3. Damages the heart muscle
4. Negative effect on reproductive glands

My teacher Mr Wang Shou Chuan (汪受传) did say that in 300 cases he followed through with, only 2 cases exhibited a fall in WBC levels and only some showed increase in liver enzyme levels.

Tripterygium is a stem. In the past, we used to remove the bark. Now we use an extracted comound called Tripterygium Polyglycoside (雷公藤多苷).

Interestingly, reports say that this herb is not useful in the treatment of hematuria, and only in proteinuria.

The typical dosage is 1-2mg/kg of the Tripterygium Polyglycoside Tablet each day, divided into 2 to 3 servings. 3 months is a typical treatment plan, with reduction in dosage as the long term plan.

Case study on Dosaging

A six-year old with Nephrotic Syndrome. He was 20kg before the edema began. He takes 2mg/kg/d, which comes up to 40mg (8 tablets, each tablet weighing 5mg) a day for four weeks. Gets better. Takes qod (alternate days) for another four weeks, Next, begins reducing dosage i.e. 7.5 tablets (37.5mg) a day for the next 2 weeks, and then 7 tablets a day for the next 2 weeks and so on…

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