doi: 10.1023/a:1010959300545 98 MiddletonFAMirnicsKPierriJNLewisDALevittP
Secondary NS arises as a consequence of other systemic pathologies (e.g., infections, neoplasms, systemic lupus erythematosus, diabetes) or the improper use of nephrotoxic substances (e.g., medications) ( If a patient is unresponsive to steroid treatment, the current guidelines recommend escalating therapy by combining immunosuppressive drugs such as calcineurin inhibitors (Cyclosporin, Tacrolimus), mycophenolate mofetil, anti-CD20 monoclonal antibodies (Rituximab, Ofatumumab), and CTLA- 4 (Abatacept, Belatacept)
improving HDL vs LDL ratios and showing some signs of lean muscle gain (Olson et al, 2012)
Initial Loading Phase Protocol In this first step, patients get B12 shots every day for one to two weeks
Ahrn B, Leguizamo Dimas A, Miossec P, et al
Lancet 2010;375:22342243