Secondary prevention

For children with frequently relapsing and corticosteroid-dependent nephrotic syndrome (NS) who are either on alternate day dosing or not taking corticosteroids, daily corticosteroid therapy for 5-7 days is recommended during episodes of upper respiratory tract and other infections to reduce the risk of relapse.​[3]​

To minimise the risk of osteoporosis, ensure adequate dietary calcium intake, or start calcium supplementation in those with inadequate intake, in all children treated with corticosteroids.[2]​ Vitamin D levels should be assessed in patients with frequently-relapsing or corticosteroid-dependent NS and supplementation guided by serum levels.[2]​[3]​

Live vaccines are generally contraindicated in patients who take daily immunosuppressants.[2]​

Children in the acute nephrotic state are at increased risk for venous and arterial thromboembolic events that disappear when the child achieves remission. Patients and families should be counselled to make them aware of possible risk factors and of the symptoms of thromboembolic complications and physical activity (and avoidance of immobilisation) encouraged.[2]​

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