From the Research
Introduction to Nephrotic Syndrome in Children
Nephrotic syndrome (NS) is a common pediatric kidney disease characterized by massive proteinuria, hypoalbuminemia, and edema 1. The clinical and laboratory characteristics of NS in children are crucial for diagnosis, treatment, and management.
Clinical Characteristics
The clinical characteristics of NS in children include edema, proteinuria, hypoalbuminemia, and hyperlipidemia 2. Children with NS may also present with hematuria, hypertension, and infections such as peritonitis and pneumonia 3, 4.
Laboratory Characteristics
Laboratory characteristics of NS in children include nephrotic-range proteinuria, hypoalbuminemia, and hyperlipidemia 2, 5. Urine protein/creatinine ratio and urine dipstick tests can also be used to diagnose NS 5.
Pathological Features
The pathological features of NS in children include minimal change disease, focal segmental glomerulosclerosis (FSGS), and other glomerular diseases 3, 4. FSGS is usually resistant to corticosteroids and carries a significant risk of kidney failure 2.
Treatment and Management
Treatment of NS in children includes corticosteroids, immunosuppressive medications, and supportive care 2, 4. Steroid-sensitive cases are treated with corticosteroids, while steroid-resistant cases may require immunosuppressive medications 4. The dosage and duration of treatment vary depending on the severity of the disease and the response to treatment.
Treatment Options
- Corticosteroids: prednisone 2 mg/kg/day for 4-6 weeks 4
- Immunosuppressive medications: cyclophosphamide, cyclosporine, and mycophenolate mofetil 2
- Supportive care: diuretics, antihypertensives, and lipid-lowering agents 2
Differentials and Caveats
Differential diagnoses of NS in children include other glomerular diseases, systemic diseases such as lupus, and genetic disorders 1, 2. Caveats include the risk of disease relapses, kidney failure, and infections 3, 4.
Conclusion
In conclusion, the clinical and laboratory characteristics of NS in children are crucial for diagnosis, treatment, and management. A comprehensive understanding of the pathological features, treatment options, and differentials is essential for healthcare providers to provide optimal care for children with NS 1, 3, 2, 5, 4.