Evaluation and management of steroid-unresponsive nephrotic syndrome.

Abstract:

PURPOSE OF REVIEW:Idiopathic nephrotic syndrome in children is commonly associated with minimal change disease and response to steroid therapy. Steroid-unresponsive nephrotic syndrome is often characterized by persistent proteinuria and progression to chronic kidney disease. Focal segmental glomerulosclerosis is the leading cause of steroid-unresponsive nephrotic syndrome in childhood. There is no uniformed consensus as to the treatment of steroid-unresponsive nephrotic syndrome. Advances in the pathogenesis, genetics and biomarkers or surrogate markers may be useful for the diagnosis and identification of patients with steroid-unresponsive nephrotic syndrome, severity of disease, progression and response to therapy. RECENT FINDINGS:This review is intended to describe some of the recent changes in the epidemiology of steroid-unresponsive nephrotic syndrome, in particular focal segmental glomerulosclerosis, its pathogenesis and alternative therapies. SUMMARY:Recent studies in both children and adults have shown an increase in the incidence of focal segmental sclerosis as a cause of steroid-unresponsive nephrotic syndrome. Advances in the pathogenesis and noninvasive methods of diagnosis may allow for the identification of steroid-responsive patients.

journal_name

Curr Opin Pediatr

authors

Del Rio M,Kaskel F

doi

10.1097/MOP.0b013e3282f4e6e4

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

151-6

issue

2

eissn

1040-8703

issn

1531-698X

pii

00008480-200804000-00009

journal_volume

20

pub_type

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