Department of Pediatrics, Wayne State University School of Medicine, 400 Mack Avenue, Suite 1 East, Detroit, MI 48201, USA.
American University of Beirut Medical Center, Beirut, Lebanon.
Pediatr Clin North Am. 2022 Dec;69(6):1079-1098. doi: 10.1016/j.pcl.2022.08.002. Epub 2022 Oct 29.
Nephrotic syndrome in children is mostly idiopathic in origin. About 90% of patients respond to corticosteroids; 80-90% have at least one relapse and 3-10% become corticosteroid resistant after the initial response. A kidney biopsy is seldom indicated for diagnosis except in patients with atypical presentation or corticosteroid resistance. For those in remission, the risk of relapse is reduced by the administration of daily low dose corticosteroids for 5-7 days at the onset of an upper respiratory infection. Some patients may continue having relapses through adult life. Many country-specific practice guidelines have been published, which are very similar with clinically insignificant differences.
儿童肾病综合征多为特发性。约 90%的患者对皮质类固醇有反应；80-90%的患者至少有一次复发，3-10%的患者在初始反应后对皮质类固醇耐药。肾活检除了在表现不典型或皮质类固醇耐药的患者中很少用于诊断。对于缓解的患者，在上呼吸道感染发作时，给予每日低剂量皮质类固醇 5-7 天，可以降低复发的风险。一些患者可能会在成年后继续复发。许多国家特有的实践指南已经发布，它们之间存在非常相似的临床差异。
