Treatment of steroid-resistant nephrotic syndrome in children: new guidelines from KDIGO

Pediatr Nephrol. 2013 Mar;28(3):409-14. doi: 10.1007/s00467-012-2304-8. Epub 2012 Oct 5.

Abstract

Kidney Disease: Improving Global Outcomes (KDIGO) recently published the clinical practice guideline on glomerulonephritis (GN) to assist the practitioner caring for patients with GN. Chapter 4 of the guideline focuses on managing children aged 1-18 years with steroid-resistant nephrotic syndrome (SRNS), defined by an inability to achieve complete remission with corticosteroid therapy. Guideline development followed a thorough evidence review, and management recommendations and suggestions were based on the best available evidence. Limitations of the evidence, including the paucity of large-scale randomized controlled trials, are discussed. This article provides both the guideline recommendations and a brief review of relevant treatment trials related to each recommendation. This précis serves as a summary of the complete guidelines recently published.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use*
  • Child
  • Child, Preschool
  • Consensus
  • Evidence-Based Medicine / standards
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Nephrology / standards*
  • Nephrotic Syndrome / congenital*
  • Nephrotic Syndrome / diagnosis
  • Nephrotic Syndrome / drug therapy
  • Remission Induction
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents

Supplementary concepts

  • Nephrotic syndrome, idiopathic, steroid-resistant