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Nephrotic Syndrome, Pediatric

Nadine M. Khouzam, MD and Kevin V. Lemley, MD, PhD Reviewed 10/2018
 


BASICS

DESCRIPTION

Nephrotic syndrome (NS) is defined by nephrotic-range proteinuria, hypoalbuminemia, edema, and hypercholesterolemia. Nephrotic-range proteinuria is typically found when there is 3 to...

DIAGNOSIS

HISTORY

  • Inquire about atopy or food sensitivity.

  • Inquire about drug exposure (especially NSAID agents).

  • Inquire about any recent infections.

  • Try to establish recent nonedematous weight.

  • Signs and...

TREATMENT

GENERAL MEASURES

  • PPD, interferon-gamma-release (IGRA), and/or chest radiograph at initial presentation prior to starting corticosteroids if risk factors for tuberculosis are present

  • Low-salt d...

ONGOING CARE

  • Influenza vaccination yearly

  • Full pneumococcal vaccination with PCV13 when needed and 23-valent pneumococcal vaccine

FOLLOW-UP RECOMMENDATIONS

  • When to expect improvement: Remission usually o...

ADDITIONAL READING

  • Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet.  2003;362(9384):629–639. [View Abstract on OvidInsights]

  • Gipson DS, Massengill SF, Yao L, et al. Management of child...

CODES

ICD9

  • 581.9 Nephrotic syndrome with unspecified pathological lesion in kidney

  • 581.3 Nephrotic syndrome with lesion of minimal change glomerulonephritis

  • 582.1 Chronic glomerulonephritis with lesion o...

FAQ

  • Q: Will the MCNS recur?

  • A: The clinical course tends to be one of multiple remissions and relapses. Relapses usually improve around the time of puberty.

  • Q: Can the NS return in adult life?

  • A: Yes.

  • Q: ...

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