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Published on: May 6, 2018
Management of childhood onset nephrotic syndrome
Debbie S Gipson1, Susan F Massengill, Lynne Yao
1Division of Nephrology and Hypertension, Department ofMedicine and Pediatrics, University of North Carolina, ChapelHill, North Carolina 27599-7155, USA. debbie_gipson@med.unc.edu
Insights
This guideline addresses childhood nephrotic syndrome, updating therapeutic approaches for focal segmental glomerulosclerosis, obesity, and diabetes. It aims to improve educational, therapeutic, and research strategies for pediatric kidney disease.
Area of Science:
- Pediatric Nephrology
- Clinical Guidelines
Background:
- Childhood nephrotic syndrome treatment evolved from 1967 International Study of Kidney Disease in Children research.
- Recent decades show increased focal segmental glomerulosclerosis, obesity, and diabetes in pediatric nephrotic syndrome.
- These comorbidities present therapeutic challenges, including glucocorticoid resistance and exacerbation.
Framework:
- The Children's Nephrotic Syndrome Consensus Conference systematically reviewed existing literature.
- A guideline for primary nephrotic syndrome in children was developed.
Implementation:
- The guideline serves educational, therapeutic, and research purposes.
- It provides a standardized approach to managing pediatric nephrotic syndrome.
Implications:
- Aims to standardize and improve the management of childhood nephrotic syndrome.
- Facilitates evidence-based decision-making for clinicians and researchers.
- Supports advancements in pediatric kidney disease treatment and understanding.
Abstract:
The therapeutic approach to childhood nephrotic syndrome is based on a series of studies that began with an international collaborative effort sponsored by the International Study of Kidney Disease in Children in 1967. The characteristics of children presenting with nephrotic syndrome have changed over recent decades with greater frequency of the challenging condition focal segmental glomerulosclerosis and a greater prevalence of obesity and diabetes mellitus, which may be resistant to glucocorticoids in the former and exacerbated by long-term glucocorticoid therapy in the latter 2 conditions. The Children's Nephrotic Syndrome Consensus Conference was formed to systematically review the published literature and generate a children's primary nephrotic syndrome guideline for use in educational, therapeutic, and research venues.
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