Management of steroid sensitive nephrotic syndrome: revised guidelines.
BACKGROUND
In 2001, the Indian Pediatric Nephrology Group formulated guidelines for management of patients with steroid sensitive nephrotic syndrome. In view of emerging scientific evidence, it was felt necessary to review the existing recommendations.


METHODS
Following a preliminary meeting in March 2007, a draft statement was prepared and circulated among pediatric nephrologists in the country to arrive at a consensus on the evaluation and management of these patients.


OBJECTIVE
To revise and formulate recommendations for management of steroid sensitive nephrotic syndrome.


CONCLUSIONS
The need for adequate cortico-steroid therapy at the initial episode is emphasized. Guidelines regarding the initial evaluation, indications for renal biopsy and referral to a pediatric nephrologist are updated. It is proposed that patients with frequently relapsing nephrotic syndrome should, at the first instance, be treated with long-term, alternate-day prednisolone. The indications for use of alternative immunosuppressive agents, including levamisole, cyclophosphamide, mycophenolate mofetil and cyclosporin are outlined. The principles of dietary therapy, management of edema, and prevention and management of complications related to nephrotic syndrome are described. These guidelines, formulated on basis of current best practice, are aimed to familiarize physicians regarding management of children with steroid sensitive nephrotic syndrome.
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. arvindbagga@hotmail.com
Bagga
Arvind
A
Ali
Uma
U
Banerjee
Sushmita
S
Kanitkar
Madhuri
M
Phadke
Kishore D
KD
Senguttuvan
Prabha
P
Sethi
Sidharth
S
Shah
Mehul
M
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007978:Levamisole / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D009752:Nutritional Status; D011239:Prednisolone / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use*; D012008:Recurrence; D017211:Treatment Failure
D000276:Adjuvants, Immunologic; D005938:Glucocorticoids; D007978:Levamisole; D003520:Cyclophosphamide; D011239:Prednisolone; D009173:Mycophenolic Acid; D011241:Prednisone