Conventional therapy for idiopathic nephrotic syndrome in children

Abstract

In children, the most frequent type of idiopathic nephrotic syndrome is the minimal-change nephrotic syndrome (MCNS). Its treatment is aimed at inducing remission, preventing relapses and avoiding side-effects. Minimal-change disease is responsive to immunosuppressive therapy. The conventional treatment consists of glucocorticosteroids and the most widely used derivative is prednisone. Initial treatment should be intensive, for example, prednisone for 12 weeks, in order to reduce the risk of subsequent relapse. Treatment of relapses should be standardized in order to categorize the patient's disease for further treatment. If a frequent relapser develops signs of steroid toxicity, alkylating drugs should be prescribed: cyclophosphamide or chlorambucil for eight weeks for frequent relapsers who are not steroid-dependent; cyclophosphamide for 12 weeks for those who are. In steroid-resistant cases, a renal biopsy is indicated and treatment should be administered according to histological changes.