NEPHROTIC SYNDROME IN CHILDHOOD

Abstract

The Nephrotic syndrome (NS) is neither a single disease nor even a heterogeneous group of related diseases. Rather it is a clinical entity characterized by oedema, heavy proteinuria ( predominantly albuminuria) and hypoprotienemia ,(predominantly hypoalbuminemia), Hyperlipidemia and lipidurias phenomena secondaty to the albuminuria or hypoalbuminemia. In The Nephrotic syndrome The protein excretion rates are usually an

.. excess of 3.5g I day I 1.73

? m- body surface area

• m the absencs of a depressed

Glomerular filtration rate . Ns may be primary or secondary to an overt systemic disease and congenital NS. In children the commonest variety of primary NS is the minimal change disease, and it is more common in boys than girls, commonly appears between the age of2-6 years.

The aim of this work is to revise the literature concerned with the recent lines of mangement of primary nephrotic syndrome in children. The diagnosis of NS depends on clinical manifestation, laboratory finding and renal biopsy at specific indication . As regard the management, numerous therapeutic regimens have been tried with varying success. General measure for all types include dietetic measures A balanced diet, adequate in both energy and protein is recommended but no systemic dietary advice is recommended in simple cases of St roid Sensitive nephrotic syndrome. The intake of sodium should be restricted to reduce the positive sodium balance. It is generally sufficient to recommend not adding salt to the diet , also the use of diuretics, and the use of antibiotics if peritonitis does occur. But the specific treatment differs according to the histological type of NS. In minimal change disease corticosteroids are the drug of choice.