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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ital+J+Pediatr
2017 ; 43
(1
): 41
Nephropedia Template TP
gab.com Text
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English Wikipedia
The Italian Society for Pediatric Nephrology (SINePe) consensus document on the
management of nephrotic syndrome in children: Part I - Diagnosis and treatment of
the first episode and the first relapse
#MMPMID28427453
Pasini A
; Benetti E
; Conti G
; Ghio L
; Lepore M
; Massella L
; Molino D
; Peruzzi L
; Emma F
; Fede C
; Trivelli A
; Maringhini S
; Materassi M
; Messina G
; Montini G
; Murer L
; Pecoraro C
; Pennesi M
Ital J Pediatr
2017[Apr]; 43
(1
): 41
PMID28427453
show ga
This consensus document is aimed at providing an updated, multidisciplinary
overview on the diagnosis and treatment of pediatric nephrotic syndrome (NS) at
first presentation. It is the first consensus document of its kind to be produced
by all the pediatric nephrology centres in Italy, in line with what is already
present in other countries such as France, Germany and the USA. It is based on
the current knowledge surrounding the symptomatic and steroid treatment of NS,
with a view to providing the basis for a separate consensus document on the
treatment of relapses. NS is one of the most common pediatric glomerular
diseases, with an incidence of around 2-7 cases per 100000 children per year.
Corticosteroids are the mainstay of treatment, but the optimal therapeutic
regimen for managing childhood idiopathic NS is still under debate. In Italy,
shared treatment guidelines were lacking and, consequently, the choice of steroid
regimen was based on the clinical expertise of each individual unit. On the basis
of the 2015 Cochrane systematic review, KDIGO Guidelines and more recent data
from the literature, this working group, with the contribution of all the
pediatric nephrology centres in Italy and on the behalf of the Italian Society of
Pediatric Nephrology, has produced a shared steroid protocol that will be useful
for National Health System hospitals and pediatricians. Investigations at initial
presentation and the principal causes of NS to be screened are suggested. In the
early phase of the disease, symptomatic treatment is also important as many
severe complications can occur which are either directly related to the
pathophysiology of the underlying NS or to the steroid treatment itself. To date,
very few studies have been published on the prophylaxis and treatment of these
early complications, while recommendations are either lacking or conflicting.
This consensus provides indications for the prevention, early recognition and
treatment of these complications (management of edema and hypovolemia, therapy
and prophylaxis of infections and thromboembolic events). Finally,
recommendations about the clinical definition of steroid resistance and its
initial diagnostic management, as well as indications for renal biopsy are
provided.