Steroid Resistant Nephrotic Syndrome

Question 1

Steroids resistance nephrotic syndrome in child is an absolute indication for

Answer 1

Biopsy

FSGS (Genetic)
Steroid resistant MCD

Question 2

Treatment for steroid resistant MCD is

Answer 2

Calcineurin inhibitors (DOC)

Cyclosporin
Tacrolimus
(No cosmetic disfigurement)

Levamisole ( not much efficacy)

Question 3

How many people will relapse

Answer 3

2/3rds of people

Frequent relapsers( 2 or more relapses)
Steroid dependent nephrotic syndrome

Question 4

Relapse in MCD

Answer 4

Protenuria reappear after 4 weeks of remission

Question 5

What do u do for relapse

Answer 5

Continue steroids and monitor urine daily

Urine albumin nil for 2 days (tapering of steroid)

Question 6

Frequently relapsing child is added with

Answer 6

Cyclophosphamide oral 2mg/kg 12 weeks

Question 7

Steroid dependent nephrotic syndrome

Answer 7

Protenuria within 14 days of stopping steroid or while on tapering dose of steroid

Question 8

DOC for steroid dependent nephrotic syndrome

Answer 8

Calcineurin inhibitors

Tacrolimus
Cyclosporin

Question 9

Steroid dependent and requent replases drug after not responding to calcineurin inhibitors

Answer 9

Rituximab 375mg/msq 4 doses one week apart vacation time