Nephrotic Syndrome: Relapsing and Steroid-Dependent Disease
22 Questions
2 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the definition of Steroid-Dependent Nephrotic Syndrome (SDNS)?

  • SSNS with 2 or more consecutive relapses during tapering or within 14 days of stopping steroids (correct)
  • NS return immediately after limiting or stopping steroid
  • SSNS with 2 or more relapses within 6 months or three times or more within 1 year period
  • FRNS with 2 or more relapses within 3 months

    • What is the dosage of prednisone prescribed for FRNS and SDNS?

  • 1.5 mg/kg/d
  • 3 mg/kg/d
  • 2 mg/kg/d (correct)
  • 4 mg/kg/d

    • What is the recommended treatment for FSGS and SRNS?

  • Prednisone
  • Cyclosporin A (correct)
  • Alkylating agents
  • Cyclophosphamide

    • What is the duration of Cyclophosphamide (CYP) treatment?

    <p>8-12 weeks</p> Signup and view all the answers

    What is the indication for performing a diagnostic renal biopsy?

    <p>After 8 weeks of steroid therapy</p> Signup and view all the answers

    What is the definition of Frequently Relapsing Nephrotic Syndrome (FRNS)?

    <p>SSNS with 2 or more relapses within 6 months or three times or more within 1 year period</p> Signup and view all the answers

    What is the reduced dosage of prednisone after remission of proteinuria?

    <p>1.5 mg/kg</p> Signup and view all the answers

    What is the side effect of Cyclophosphamide (CYP) treatment?

    <p>All of the above</p> Signup and view all the answers

    What is the primary indication for considering steroid treatment prior to kidney biopsy?

    <p>Absence of systemic disease symptoms</p> Signup and view all the answers

    What is the maximum daily dose of oral prednisone for induction therapy?

    <p>60 mg</p> Signup and view all the answers

    What is the purpose of maintenance therapy after induction therapy?

    <p>To reduce the frequency of relapses</p> Signup and view all the answers

    What is the dosage of prednisone for treatment of relapses?

    <p>2 mg/kg/d</p> Signup and view all the answers

    What is the reason for giving prednisone as a single dose on alternate days?

    <p>To reduce the side effects of the drug</p> Signup and view all the answers

    What is the duration of maintenance therapy after induction therapy?

    <p>6 weeks</p> Signup and view all the answers

    What is the significance of normal complement levels in patients being considered for steroid treatment?

    <p>It excludes APSGN</p> Signup and view all the answers

    What is the age criterion for considering patients for steroid treatment prior to kidney biopsy?

    <p>1-8 years</p> Signup and view all the answers

    What is a potential complication of administering 25% albumin to a patient with anasarca and signs of intravascular volume depletion?

    <p>Shock due to decreased volume</p> Signup and view all the answers

    Which of the following vaccinations is contraindicated in patients with nephrotic syndrome?

    <p>Live-attenuating vaccines</p> Signup and view all the answers

    What is the definition of remission in nephrotic syndrome?

    <p>Urinary protein excretion &lt; 4 mg/m2/h or dipstick neg/trace for 3 consecutive days</p> Signup and view all the answers

    What is the term for two or more relapses within 6 months of initial response or 3 or more in 12 months in nephrotic syndrome?

    <p>Frequent relapses</p> Signup and view all the answers

    What is the minimum duration of steroid therapy required to achieve a response in nephrotic syndrome?

    <p>8 weeks</p> Signup and view all the answers

    What is the definition of nephrotic syndrome?

    <p>Edema, plasma albumin &lt; 2.5 gm/dl, proteinuria &gt; 40 mg/m2/h</p> Signup and view all the answers

    Study Notes

    Nephrotic Syndrome

    • Nephrotic syndrome is characterized by edema, plasma albumin < 2.5 gm/dl, and proteinuria > 40 mg/m2/h
    • Remission is defined as urinary protein excretion < 4 mg/m2/h or dipstick neg/trace for 3 consecutive days
    • Steroid response is achieved when remission is achieved with steroid therapy alone
    • Relapse occurs when urinary protein excretion > 40 mg/m2/h or dipstick 2+ for 3 consecutive days having previously been in remission
    • Frequent relapses are defined as two or more relapses within 6 months of initial response or 3 or more in 12 months
    • Steroid dependence is characterized by two consecutive relapses occurring during corticosteroid treatment or within 14 days of cessation
    • Steroid resistance is defined as failure to achieve response in spite of 8 weeks of prednisolone 60 mg/m2/day

    Treatment of Nephrotic Syndrome

    • For frequently relapsing and steroid-dependent disease, prednisone is prescribed at 2 mg/kg/d (60 mg/m2/d) as a single morning dose until the patient has been free of proteinuria for at least 3 days
    • Following remission of proteinuria, prednisone is reduced to 1.5 mg/kg (40 mg/m2) given as a single dose on alternate days and tapered over 3 or more months
    • A steroid-sparing agent, such as cyclophosphamide or cyclosporin A, may be considered once proteinuria is in remission
    • For steroid-resistant disease and focal segmental glomerulosclerosis (FSGS), cyclosporin A is the most frequently recommended treatment
    • Alkylating agents, such as cyclophosphamide, may be used in steroid-resistant disease

    Corticosteroid Therapy

    • Oral prednisone is prescribed at 60 mg/m2/d (2 mg/kg/d) for 6 weeks
    • Maintenance therapy involves oral prednisone at 40 mg/m2 (or 1.5 mg/kg) given as a single dose on alternate days for 6 weeks
    • Longer duration of alternate-day steroid treatment may further reduce the number of children with subsequent relapses

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    Learn about frequently relapsing and steroid-dependent nephrotic syndrome, including definitions and treatment options. Understand the differences between these two types of nephrotic syndrome.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser