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Curr Opin Pediatr. 2008 Apr;20(2):145-50. doi: 10.1097/MOP.0b013e3282f4307a.

Evaluation and management of steroid-sensitive nephrotic syndrome.

Author information

1
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia. Elisah@chw.edu.au

Abstract

PURPOSE OF REVIEW:

This review examines new literature published in 2006 and 2007 on steroid-sensitive nephrotic syndrome.

RECENT FINDINGS:

Steroid-sensitive nephrotic syndrome has long been thought to be due to lymphocyte-derived circulating factors leading to podocyte injury with subsequent proteinuria. New studies support this mechanism and implicate the T helper 2 cytokine IL-13. In addition a genetic mutation in familial nephrotic syndrome has been reported in a child, who responded to corticosteroid therapy. There are new clinical trial data supporting the efficacy of levamisole in steroid-sensitive nephrotic syndrome and preliminary trial data on mycophenolate mofetil supporting its efficacy as a steroid-sparing agent. Case reports support the use of the B cell-depleting antibody rituximab in steroid-sensitive nephrotic syndrome. Finally there is a meta-analysis of six studies suggesting an increase in the incidence of focal and segmental glomerulosclerosis in steroid-sensitive nephrotic syndrome over the last 20 years.

SUMMARY:

Progress has been made towards elucidating the cause of steroid-sensitive nephrotic syndrome. Data from adequately powered randomized controlled trials are still required to evaluate therapies for frequently relapsing and steroid-dependent steroid-sensitive nephrotic syndrome.

PMID:
18332709
DOI:
10.1097/MOP.0b013e3282f4307a
[Indexed for MEDLINE]

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