KIDNEY FOUNDATION FOR CHILDREN
SAVING YOUNG LIVES
Nephrotic syndrome is a spot diagnosis.Once seen, never forgotten. Confirming the diagnosis needs only 3 tests- Urine routine, serum albumin and cholesterol.
Tests not needed for making the diagnosis but which are always needed are BUN,serum creatinine and a complete blood count.It may be prudent to do a mantoux test and chest xray prior to starting steroid therapy.
Additional tests are not needed in children presenting after one year of age unless there is gross hematuria, persistent hypertension, elevated creatinine or extrarenal symptoms and signs.
.Treatment of the first attack of nephrotic syndrome should be with prednisolone for a total period of 12 weeks. Treatment with appropriate dosage for 12 weeks has been shown to reduce the number of subsequent relapses and is now accepted as standard of care.Shorter courses should not be given for the treatment of the first attack.Response to tablet formulations is more predictable and reliable than to liquid formulations.There is no recommendation for the use of other steroid preparations such as hydrocortisone, dexamethasone, betamethasone etc ,There is inadequate evidence for the use of deflazacort for the first attack of nephrotic syndrome.
Empiric antibiotics should NOT be given just to cover steroid therapy.
Response or remission within first 4 weeks of daily steroids
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