Document Detail


Nephrotic syndrome in childhood.
MedLine Citation:
PMID:  12944064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Childhood nephrotic syndromes are most commonly caused by one of two idiopathic diseases: minimal-change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS). A third distinct type, membranous nephropathy, is rare in children. Other causes of isolated nephrotic syndrome can be subdivided into two major categories: rare genetic disorders, and secondary diseases associated with drugs, infections, or neoplasia. The cause of idiopathic nephrotic syndrome remains unknown, but evidence suggests it may be a primary T-cell disorder that leads to glomerular podocyte dysfunction. Genetic studies in children with familial nephrotic syndrome have identified mutations in genes that encode important podocyte proteins. Patients with idiopathic nephrotic syndrome are initially treated with corticosteroids. Steroid-responsiveness is of greater prognostic use than renal histology. Several second-line drugs, including alkylating agents, ciclosporin, and levamisole, may be effective for complicated and steroid-unresponsive MCNS and FSGS patients. Nephrotic syndrome is associated with several medical complications, the most severe and potentially fatal being bacterial infections and thromboembolism. Idiopathic nephrotic syndrome is a chronic relapsing disease for most steroid-responsive patients, whereas most children with refractory FSGS ultimately develop end-stage renal disease. Research is being done to further elucidate the disorder's molecular pathogenesis, identify new prognostic indicators, and to develop better approaches to treatment.
Authors:
Allison A Eddy; Jordan M Symons
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Lancet     Volume:  362     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-28     Completed Date:  2003-10-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  629-39     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Washington, Children's Hospital and Regional Medical Center, Seattle, WA 98105, USA. allison.eddy@seattlechildrens.org
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Age Factors
Child
Child, Preschool
Cyclosporine / therapeutic use
Humans
Infant
Infant, Newborn
Nephrotic Syndrome* / diagnosis,  drug therapy
Grant Support
ID/Acronym/Agency:
DK54500/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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