| Evaluation and management of steroid-unresponsive nephrotic syndrome. | |
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MedLine Citation:
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PMID: 18332710 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Marcela Del Rio; Frederick Kaskel |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review |
Journal Detail:
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Title: Current opinion in pediatrics Volume: 20 ISSN: 1040-8703 ISO Abbreviation: Curr. Opin. Pediatr. Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-11 Completed Date: 2008-08-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9000850 Medline TA: Curr Opin Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 151-6 Citation Subset: IM |
Affiliation:
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Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York 10467, USA. mdelrio@montefiore.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Child Cyclosporins / therapeutic use Glomerulosclerosis, Focal Segmental / complications Humans Immunosuppressive Agents / therapeutic use Mycophenolic Acid / analogs & derivatives, therapeutic use Nephrotic Syndrome / diagnosis*, drug therapy*, etiology Randomized Controlled Trials as Topic Sirolimus / therapeutic use Tacrolimus / therapeutic use Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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U01 DK066174/DK/NIDDK NIH HHS; U01 DK63549/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Cyclosporins; 0/Immunosuppressive Agents; 109581-93-3/Tacrolimus; 128794-94-5/mycophenolate mofetil; 24280-93-1/Mycophenolic Acid; 53123-88-9/Sirolimus |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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