IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome.
Idiopathic nephrotic syndrome is the most frequent pediatric glomerular disease, affecting from 1.15 to 16.9 per 100,000 children per year globally. It is characterized by massive proteinuria, hypoalbuminemia, and/or concomitant edema. Approximately 85–90% of patients attain complete remission of pr...
| Publicado en: | Pediatric Nephrology Vol. 38; no. 3; pp. 877 - 920 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161327151&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 161327151 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Mar2023 vid: 38 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 161327151 159782361 161327151 161327151 10.1007/s00467-022-05739-3 161327151 ppf: 877 ppct: 43 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome. aug: au: Trautmann, Agnes Boyer, Olivia Hodson, Elisabeth Bagga, Arvind Gipson, Debbie S. Samuel, Susan Wetzels, Jack Alhasan, Khalid Banerjee, Sushmita Bhimma, Rajendra Bonilla-Felix, Melvin Cano, Francisco Christian, Martin Hahn, Deirdre Kang, Hee Gyung Nakanishi, Koichi Safouh, Hesham Trachtman, Howard Xu, Hong Cook, Wendy affil: Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany sug: subj: Nephrotic Syndrome Diagnosis Nephrotic Syndrome Drug Therapy Steroids Adverse Effects Glucocorticoids Therapeutic Use Disease Management Recurrence Risk Factors Glucocorticoids Administration and Dosage Morbidity Immunosuppressive Agents Medical Practice, Evidence-Based Nephrologists Treatment Outcomes Drug Toxicity Practice Guidelines Human Male Female Child Funding Source Child: 6-12 years Male Female ab: Idiopathic nephrotic syndrome is the most frequent pediatric glomerular disease, affecting from 1.15 to 16.9 per 100,000 children per year globally. It is characterized by massive proteinuria, hypoalbuminemia, and/or concomitant edema. Approximately 85–90% of patients attain complete remission of proteinuria within 4–6 weeks of treatment with glucocorticoids, and therefore, have steroid-sensitive nephrotic syndrome (SSNS). Among those patients who are steroid sensitive, 70–80% will have at least one relapse during follow-up, and up to 50% of these patients will experience frequent relapses or become dependent on glucocorticoids to maintain remission. The dose and duration of steroid treatment to prolong time between relapses remains a subject of much debate, and patients continue to experience a high prevalence of steroid-related morbidity. Various steroid-sparing immunosuppressive drugs have been used in clinical practice; however, there is marked practice variation in the selection of these drugs and timing of their introduction during the course of the disease. Therefore, international evidence-based clinical practice recommendations (CPRs) are needed to guide clinical practice and reduce practice variation. The International Pediatric Nephrology Association (IPNA) convened a team of experts including pediatric nephrologists, an adult nephrologist, and a patient representative to develop comprehensive CPRs on the diagnosis and management of SSNS in children. After performing a systematic literature review on 12 clinically relevant PICO (Patient or Population covered, Intervention, Comparator, Outcome) questions, recommendations were formulated and formally graded at several virtual consensus meetings. New definitions for treatment outcomes to help guide change of therapy and recommendations for important research questions are given. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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