Treatment for Fairness Cream Induced Nephrotic Syndrome

Initial Management

The Kidney International guideline recommends starting high-dose glucocorticoids (prednisone or prednisolone) at 1 mg/kg/day (maximum 80 mg) for initial treatment 1

The Kidney International guideline recommends administering high-dose glucocorticoids for a total of 8-12 weeks instead of the previously recommended 24 weeks (Grade 1B) 1, 2
The Kidney International guideline suggests continuing high-dose glucocorticoids until complete remission is achieved, then taper slowly over 6 months 3
For steroid-resistant cases, the Kidney International guideline recommends considering calcineurin inhibitors (CNIs) as second-line therapy, such as cyclosporine: 3-5 mg/kg/day in divided doses (target trough level: 100-175 ng/ml) 4, 5
The Kidney International and American Journal of Kidney Diseases guidelines recommend considering tacrolimus: 0.05-0.1 mg/kg/day in divided doses (target trough level: 5-10 ng/ml) as an alternative CNIs 6, 7

The Kidney International guideline suggests initiating calcineurin inhibitors for at least 6 months if there is no response to glucocorticoids after 4-6 months 6, 8

The Kidney International guideline recommends considering steroid-sparing agents such as mycophenolate mofetil, rituximab, or cyclophosphamide for patients with steroid-dependent or frequently relapsing nephrotic syndrome 1, 2
The Kidney International guideline suggests providing appropriate renal replacement therapy while continuing immunosuppressive treatment in cases of acute kidney injury 3
The Kidney International guideline recommends considering genetic testing in steroid-resistant cases to rule out genetic causes of nephrotic syndrome 1, 2