Nephrotic syndrome refractory to standard treatment poses a challenging problem to paediatric nephrologists. Management issues involve many inter-dependent factors, including fluid status, kidney function, nutrition, infection and thrombosis risks. We will present a case of a child with primary nephrotic syndrome refractory to standard treatment. This session will address common management challenges of a nephrotic child, immunosuppressive strategies and general approach to genetic testing.
- Outline definition of steroid resistant and multi drug resistant Nephrotic syndrome
- Understand common challenges in managing the “difficult to treat” nephrotic state
- Understand the factors to consider in selecting different immunosuppressive strategies
- Understand approaches and pitfalls in genetic testing
- Trautmann, A., Vivarelli, M., Samuel, S. et al. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome. Pediatr Nephrol 35, 1529–1561 (2020). https://doi.org/10.1007/s00467-020-04519-1