Ok well you seem to have a grasp on this and I know next to nothing about it, what people should be worried about this
I know the basics when it comes to this stuff, but definitely not an expert, lol. Nephrotic syndrome is basically a disease of the glomerulus, so it's going to effect how well the kidneys filter certain substances from entering the ultrafiltrate. Usually the patient will have hypoalbuminemia (and hypercholesterolemia) from increased proteinuria. If he caught this early without too much damage, he should be fine, or at least prevent renal function from further deteriorating. I'd definitely give a big hell NO to any tren use. I'd probably recommend him go to a good endo, one who is strict but liberal (if only it were that easy
), and check options for trt only, or 10-20mg/d at most....if it were me. Controlling his BP would be at the top of the list, as well as keeping blood sugar in check. Staying hydrated, or rather, not staying in a dehydrated state for any length of time would be beneficial. I can't say if whether or not astragalus would help, i'd probably use it at some point personally, but i'm not a physician, let alone a nephrologist, to really feel comfortable enough to say it would be of benefit. That said, we know astragalus is not usually a course of action for most physicians, so it may take some trial and error on his own behalf to really know. The newer SGLT-2 inhibitor drugs (Empagliflozin/Jardiance like
@nothuman mentioned) may be the course of action to take, as they will decrease proteinuria to some degree. The problem with something like FSGS is that it's not something you can just walk in and have checked out. I know when I was doing my dialysis rotations, I believe they used electron microscopy, but that may be different now. Maybe a physician or somebody in the know can update that? The OP stated he was having a biopsy, so i'll be interested to see what that shows. Getting a good BP monitor should be a must, and if he needs meds for it, that should be a no-brainer for a physician to prescribe. I had to get one with a larger cuff, as smaller ones, at least when I worked at a local heart hospital, always put my BP 20-30 points higher. That said, they can be found. I would not cut sodium, but rather keep it neutral during everything without increasing it or lowering it. Then go from there with it. There is going to need to be some trial and error with all this form him, but nothing he shouldn't be able to do with some time and seeing how everything affects him.
I'd actually want to know from the OP what tests they have completed thus far to lead to the current diagnosis....or of they are just assuming that this may be worse case scenario? Will probably make a different post after this one in case he does not read this post, lol.
@Type-IIx stated other courses of action on how AAS can negatively effect kidney health.
A quick search yielded the following study for SGLT-2 inhibitor use for nephrotic syndrome, but maybe something more recent has come out.
ABSTRACT. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are a class of novel oral anti-hyperglycemic agents which are increasingly used in clinical pr
academic.oup.com
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