[Refractory nephrotic syndrome].
In Japan, refractory nephrotic syndrome is defined as a pathological condition resistant to the treatment using corticosteroids and other immunosuppressive for 6 months or more. The Research Group on Progressive Renal Disease sponsored by the Ministry of Health Labor and Welfare of Japan reported that 10 to 12% of the cases with idiopathic nephrotic syndrome were classified into this type and that the most common cause in adults is idiopathic membranous nephropathy (40%) and the second is focal segmental glomerulosclerosis (20%). In these conditions, less than 10% progressed to end stage renal disease (ESRD) when urine protein decreased under 1 g/day by the treatment. Persistent proteinuria is not only a marker of irreversible glomerular lesions but also a risk factor for tubulointerstitial lesions, which plays a significant role in progression into ESRD.
Saito
Takao
T
Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000925:Anticoagulants / Q000008:administration & dosage; D015415:Biomarkers / Q000652:urine; D001781:Blood Component Removal; D004351:Drug Resistance; D015433:Glomerulonephritis, Membranous / Q000150:complications; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007676:Kidney Failure, Chronic / Q000209:etiology; D008077:Lipoproteins, LDL / Q000302:isolation & purification; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000209:etiology; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D011507:Proteinuria; D012307:Risk Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D015415:Biomarkers; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D008077:Lipoproteins, LDL; D011239:Prednisolone