LET'S Pediatric Idiopathic Nephrotic Syndrome

Pediatric patients with nephrotic syndrome (NS) can exhibit proteinuria, hypoalbuminemia, edema, and dyslipidemia. Morbidity and mortality associated with nephrotic syndrome, including progression to end-stage renal disease (ESRD), are reduced with treatment. Idiopathic NS occurs more often than NS from secondary causes in pediatric patients. Corticosteroids are used first-line to induce remission and are effective in most pediatric patients. Inadequate response to corticosteroids dictates the need for adjunctive or alternative therapies such as alkylating agents, calcineurin inhibitors, mycophenolate mofetil, and rituximab. These strategies are useful for patients who do not remit with steroids, who frequently relapse, or who are corticosteroid-dependent.