Management of the difficult nephrotic patient.
Most children with nephrotic syndrome do well, usually with multiple relapses and remissions. Some children require high doses of oral steroids to sustain a remission and develop significant steroid toxicity. These patients frequently can be managed with oral alkylating agents or with cyclosporine. A few nephrotic children to not respond to oral prednisone. The most common biopsy finding in steroid-resistant patients is focal segmental glomerulosclerosis. Many patients with this condition progress to chronic renal failure. Evidence suggests that the outcome is improved with either cyclosporine or with a protocol using pulse intravenous methylprednisolone and oral alkylating agents.
Mendoza
S A
SA
Department of Pediatrics, University of California, School of Medicine, San Diego, USA.
Tune
B M
BM
D002648:Child; D005260:Female; D006801:Humans; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids