Nephrotic syndrome.
On the basis of observational studies, the most common cause of nephrotic syndrome in school-aged children is minimal change disease. On the basis of research evidence and consensus, corticosteroids are considered first-line therapy for treatment of nephrotic syndrome. On the basis of consensus, prednisone therapy should be initiated at doses of 60 mg/m2 per day (2 mg/kg per day) administered for 4 to 6 weeks, followed by 40 mg/m2 per dose (1.5 mg/kg) every other day for at least 6 to 8 weeks. On the basis of consensus and expert opinion, it is important to recognize and manage the complications that can arise in patients with nephrotic syndrome, such as dyslipidemia, infection, and thrombosis. On the basis of research evidence, consensus, and expert opinion, several alternative therapies have been observed to have variable efficacy in children with both corticosteroid-dependent and corticosteroid-resistant nephrotic syndrome, although caution must be exercised in the administration of these corticosteroid-sparing medications secondary to toxic adverse effects. On the basis of observational studies, the course of nephrotic syndrome in most patients is that of relapse and remission.
St. Luke's University Health Network, Bethlehem, PA. Icahn School of Medicine at Mount Sinai, New York, NY. When this review was submitted, Dr. Andolino was in her third and final year of a pediatric nephrology fellowship at Sinai.
Tecile Prince
TP
Andolino
Icahn School of Medicine at Mount Sinai, New York, NY.
Jessica
J
Reid-Adam
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D060730:Glomerular Filtration Barrier / Q000503:physiopathology; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000503:physiopathology; D008297:Male; D009404:Nephrotic Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D010372:Pediatrics / Q000193:education; D011241:Prednisone / Q000008:administration & dosage*
D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D011241:Prednisone