[Corticosteroid therapy for nephrotic syndrome]

Although the cause of primary nephrotic syndrome remains unclear, the progress of basic science has indicated that immune T cell disorders lead to glomerular dysfunctions. Patients with primary nephrotic syndrome and some of secondary nephrotic syndrome are, thereby, initially treated with high dose of corticosteroids. Steroid responsiveness is an important prognostic indicator of the disease, and in steroid-resistant patients, immunosuppressive agents and the methylprednisolone pulse therapy are recommended. Although a treatment based on corticosteroids has brought about clinical benefits, several adverse effects, including various opportunistic infections, osteoporosis/bone fracture, aseptic necrosis of femoral head, and so on, are frequent and sometimes severe and suitable preventions and urgent treatments are prerequisite in such patients.