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ISSN 0973 - 0958
Nephrotic Syndrome(NS) in Children
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NEPHROTIC SYNDROME
Continued...
Q10) How do you treat a relapse?
A10) Then again oral prednisolone therapy may be needed. The duration of course of prednisolone therapy for relapse is shorter (6-8 weeks).
Q11) When do you start steroids in a relapse?
A11) If a child has proteinuria of 2+ or more for 2-3 weeks even if there is no swelling or edema it is safer to start steroids rather than wait, because
Q10) How do you treat a relapse?
A10) Then again oral prednisolone therapy may be needed. The duration of course of prednisolone therapy for relapse is shorter (6-8 weeks).
Q11) When do you start steroids in a relapse?
A11) If a child has proteinuria of 2+ or more for 2-3 weeks even if there is no swelling or edema it is safer to start steroids rather than wait, because
all the complications of NS are related
to edema.
Q12) When is a kidney biopsy required?
A12) If the patient does not respond to oral prednisolone therapy within the prescribed time a kidney biopsy is a must .
Q13) What is the role of levamisole & when do you start & how to give?
A13) Levamisole is a drug, which is useful if NS relapses frequently i.e. more than 3 relapses within 1 year or patient relapses while on steroids i.e. Steroid dependent NS. Levamisole can control proteinuria, which is reduced by steroids sparing effect so that fewer doses of steroids is needed and in some cases steroids can be omitted.
Levamisole is started when prednisolone has produced remission (i.e. urine albumin shows nil or trace for 3 days consecutively). The dose recommended is 2.5 mg/kg on alternate day for 6-18 months with tapering dose of steroids. It is to be given after dinner at bedtime.
Q14) What is the role of Enalapril in NS?
A14) In majority of children the cause of nephrotic syndrome is not known hence there is no curative treatment. But oral prednisolone treatment is effective in controlling the protein loss in the urine which is the main problem in NS.
Q15) If the child is Hbs Ag+ve do you give steroids? What is the treatment?
A15) With HbsAg +ve, steroids are not indicated and may be harmful. Tab.Enalapril can be tried in such cases.
Q16) What is the role of immunisation?
A16) Immunisations are advised when the child is not in relapse and the dose of prednisolone is very small or when prednisolone is stopped. Vaccines for chickenpox, hepatitis-B, H, influenzae and pneumococci are important to prevent these infections which increase risk to life in a child with NS.
Q12) When is a kidney biopsy required?
A12) If the patient does not respond to oral prednisolone therapy within the prescribed time a kidney biopsy is a must .
Q13) What is the role of levamisole & when do you start & how to give?
A13) Levamisole is a drug, which is useful if NS relapses frequently i.e. more than 3 relapses within 1 year or patient relapses while on steroids i.e. Steroid dependent NS. Levamisole can control proteinuria, which is reduced by steroids sparing effect so that fewer doses of steroids is needed and in some cases steroids can be omitted.
Levamisole is started when prednisolone has produced remission (i.e. urine albumin shows nil or trace for 3 days consecutively). The dose recommended is 2.5 mg/kg on alternate day for 6-18 months with tapering dose of steroids. It is to be given after dinner at bedtime.
Q14) What is the role of Enalapril in NS?
A14) In majority of children the cause of nephrotic syndrome is not known hence there is no curative treatment. But oral prednisolone treatment is effective in controlling the protein loss in the urine which is the main problem in NS.
Q15) If the child is Hbs Ag+ve do you give steroids? What is the treatment?
A15) With HbsAg +ve, steroids are not indicated and may be harmful. Tab.Enalapril can be tried in such cases.
Q16) What is the role of immunisation?
A16) Immunisations are advised when the child is not in relapse and the dose of prednisolone is very small or when prednisolone is stopped. Vaccines for chickenpox, hepatitis-B, H, influenzae and pneumococci are important to prevent these infections which increase risk to life in a child with NS.
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Kidney Problems in Children Specialist
Answer
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