title: [Idiopathic Nephrotic Syndrome: recommendations of the Nephrology Branch of the Chilean Society of Pediatrics. Part two].
abstract: Idiopathic nephrotic syndrome is the most common glomerular disease in childhood, affecting 1 to 3 per 100,000 children under the age of 16. It most commonly occurs in ages between 2 and 10. Its cause is unknown, and its histology corresponds to minimal change disease in 90% of cases, or focal segmental glomerulosclerosis. Steroid-resistant nephrotic syndrome represents 10-20% of idiopathic nephrotic syndrome in pediatrics. It has a poor prognosis, and its management is a significant therapeutic challenge. Half of patients evolve to end-stage renal disease within 5 years, and are additionally exposed to complications secondary to persistent NS and to the adverse effects of immunosuppressive therapy. The primary goal of treatment is to achieve complete remission, but even a partial remission is associated with a better renal survival than the lack of response. This paper is the result of the collaborative effort of the Nephrology Branch of the Chilean Society of Pediatrics with aims at helping pediatricians and pediatric nephrologists to treat pediatric idiopathic nephrotic syndrome. In this second part, handling of steroid-resistant nephrotic syndrome as well as nonspecific therapies are discussed.
authors.affiliation: Unidad de Nefrología, Hospital San Juan de Dios, Santiago, Chile. Electronic address: pilarheviaj@gmail.com.
authors.forename: Pilar
authors.initials: P
authors.lastname: Hevia
authors.affiliation: Unidad de Nefrología, Hospital Metropolitano La Florida, Santiago, Chile.
authors.forename: Vilma
authors.initials: V
authors.lastname: Nazal
authors.affiliation: Unidad de Nefrología, Hospital San Juan de Dios, Santiago, Chile.
authors.forename: María Pía
authors.initials: MP
authors.lastname: Rosati
authors.affiliation: Unidad Nefrología, Hospital de Carabineros, Santiago, Chile.
authors.forename: Lily
authors.initials: L
authors.lastname: Quiroz
authors.affiliation: Unidad de Nefrología, Hospital Félix Bulnes, Santiago, Chile.
authors.forename: Claudia
authors.initials: C
authors.lastname: Alarcón
authors.affiliation: Unidad de Nefrología, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile.
authors.forename: Sonia
authors.initials: S
authors.lastname: Márquez
authors.affiliation: Unidad de Nefrología, Hospital San Juan de Dios, Santiago, Chile.
authors.forename: Karen
authors.initials: K
authors.lastname: Cuevas
mesh_terms: D002648:Child; D002677:Chile; D005923:Glomerulosclerosis, Focal Segmental / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000517:prevention & control; D009402:Nephrosis, Lipoid / Q000503:physiopathology / Q000628:therapy*; D009404:Nephrotic Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010372:Pediatrics; D011379:Prognosis; D012074:Remission Induction
keywords: Corticorresistente; Glomerulopathy; Glomerulopatía; Immunosuppressive agents; Inmunosupresores; Steroid-resistant nephrotic syndrome; Steroid-resistent; Síndrome nefrótico corticorresistente; Tratamiento; Treatment