Current Un

Apuntes

Current Understanding of Nephrotic Syndrome in Children Tej K. Mattoo, MD, DCH, FRCP (UK), FAAPa,*, Sami Sanjad, MDb INTRODUCTION Nephrotic syndrome (NS) in children is characterized by significant proteinuria, hypoalbuminemia, and edema. About 90% of cases between 1 and 10 years old, and 50% above 10 years, are idiopathic (INS). Most patients with INS respond to corticosteroids; 80–90% relapse, with nearly half experiencing frequent relapses (FR) and potentially becoming steroid dependent (SD). Additional immunosuppressive therapy is required for steroid-resistant or FR/SD cases. The prognosis for steroid responders is excellent. Approximately one-third of children diagnosed with INS may experience relapses into adulthood, especially those with more severe disease. Several country-specific guidelines exist, with minor clinical differences. This chapter focuses on steroid-sensitive INS; secondary NS and steroid-resistant NS are not covered. •[KEY POINTS] Children with NS have edema and massive proteinuria. Steroid therapy remains the standard treatment. Kidney biopsy is rarely necessary. Most patients have an excellent prognosis. Relapses can continue into adult...