2019
DOI: 10.1007/s00467-019-04225-7
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Treatment of nephrotic syndrome: going beyond immunosuppressive therapy

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Cited by 12 publications
(7 citation statements)
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References 85 publications
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“…Progressive CKD is infrequent in children or adults with minimal change lesions 6,152 but it is common among those with a podocytopathy, persistent proteinuria and FSGS lesions 157 . Response to glucocorticoids is critical in defining patient subsets 158 and prognosis 156 , as those who achieve remission (75-92% with minimal change lesions 146,159 and 47-66% in those with FSGS lesions 160 ) do not usually develop ESKD 161 . Conversely, resistance to steroids is the strongest independent predictor of kidney function decline, with a kidney survival of 30% at 10 years from diagnosis.…”
Section: Managementmentioning
confidence: 99%
See 1 more Smart Citation
“…Progressive CKD is infrequent in children or adults with minimal change lesions 6,152 but it is common among those with a podocytopathy, persistent proteinuria and FSGS lesions 157 . Response to glucocorticoids is critical in defining patient subsets 158 and prognosis 156 , as those who achieve remission (75-92% with minimal change lesions 146,159 and 47-66% in those with FSGS lesions 160 ) do not usually develop ESKD 161 . Conversely, resistance to steroids is the strongest independent predictor of kidney function decline, with a kidney survival of 30% at 10 years from diagnosis.…”
Section: Managementmentioning
confidence: 99%
“…Recommended regimens 158 derive from paediatric trials as only few adequately powered studies in adults are available [172][173][174] . Response to therapy is typically slower in adults than in children, justifying prolonged steroid courses before defining treatment failure.…”
Section: New-onset Nephrotic Syndromementioning
confidence: 99%
“…We have observed in clinical practice that the use of immunosuppressive agents similar to that in younger patients after renal biopsy can cause severe adverse effects in elderly patients, including bleeding, wasting, and even fatal infections. 23 Thirdly, the existing guidelines are mainly for middle-aged and young patients. The types, dosages, and treatment courses of drugs in the existing guidelines may not be appropriate for elderly patients, leading to difficulty in achieving effective treatment after definite diagnosis of renal biopsy.…”
Section: Discussionmentioning
confidence: 99%
“…Besides, low-dose thiazide diuretic will have an additive effect on the anti-proteinuric effect. Children and adolescent patients with new onset nephrotic syndrome in the absence of histological verification are usually treat with oral steroid therapy for two to three months ( Zhao and Liu, 2020 ). Nevertheless, due to the heterogeneous clinical behavior and response to treatment with steroid, the dose and treatment duration for the steroid should be adjusted appropriately according to clinical response.…”
Section: Podocytopathiesmentioning
confidence: 99%