Most cases of nephrotic syndrome are primary nephrotic syndrome, which refers to the absence of specific causes and may be related to immune dysfunction. The disordered immune system attacks the glomerular capillaries causing damage to the filtration barrier, resulting in the patient excreting large amounts of urinary protein. For primary nephrotic syndrome, treatment generally involves the use of corticosteroids or a combination of hormones and immunosuppressants. About 50-60% of patients respond effectively to the medication, which typically takes about two months to take effect. Patients who respond quickly might see effects within one to two weeks, while those with less sensitivity to the medication may need three to four months. The general course of medication is about one year.