title: Management of nephrotic syndrome in children.
abstract: Idiopathic childhood nephrotic syndrome generally has a favorable long-term prognosis. Prompt administration of and improved guidelines for monitoring therapy have decreased morbidity and mortality. The treatment goal is to induce prompt remission while minimizing complications and adverse events. Aggressive therapy induces remission and decreases the frequency of relapse in most patient populations; however, such treatment often results in unnecessary toxicity. We critically assessed the current clinical evidence that supports each pharmacologic therapy. For each drug regimen, the risks and monitoring parameters required to reduce complications and optimize therapy are discussed. Some of the treatments are the common corticosteroid approaches, cytotoxic therapies (chlorambucil, cyclophosphamide), cyclosporine, less frequently used drugs (e.g., levamisole), and experimental therapies. Further studies are needed to identify the most effective and least toxic therapeutic regimens for inducing and maintaining remission in children with nephrotic syndrome.
authors.affiliation: Department of Pediatrics, College of Medicine and Public Health, The Ohio State University, Columbus, Ohio, USA. Robinsonr@pediatrics.ohio-state.edu
authors.forename: Renee F
authors.initials: RF
authors.lastname: Robinson
authors.forename: Milap C
authors.initials: MC
authors.lastname: Nahata
authors.forename: John D
authors.initials: JD
authors.lastname: Mahan
authors.forename: Donald L
authors.initials: DL
authors.lastname: Batisky
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D012074:Remission Induction; D055502:Secondary Prevention; D016896:Treatment Outcome