Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that indicate kidney damage, particularly damage to the glomeruli, the tiny units within the kidney where blood is filtered result in the release of too much protein from the body into the urine. When the kidneys are damaged, the protein albumin, normally found in the blood will leak into the urine. Proteins are large, complex molecules that perform a number of important functions in the body. The two types of childhood nephrotic syndrome are Primary—the most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys. Secondary—the syndrome is caused by other diseases. Common primary causes of nephrotic syndrome include kidney diseases such as minimal-change nephropathy, membranous nephropathy, and focal glomerulosclerosis. Secondary causes include systemic diseases such as diabetes mellitus, lupus erythematosus, amyloidosis. Characteristic findings: Proteinuria, Hypoalbuminemia. Treatment includes Prednisone 2 mg/kg per day for 4-6 weeks, followed by 1.5 mg/kg per day on alternating days for other 4-6 weeks, 95% of patients with MCD will go into remission following 8 weeks of corticosteroid treatment. Remission defined as 3 consecutive days with no or trace protein on urinalysis. Confirms diagnosis of MCD. Lower rates of remission seen in patients treated for 12 week. Complications are an acute renal failure, Usually reversible with restoration of intravascular volume Thrombosis. Secondary to urinary losses of antithrombin III and protein. Infection, usually staphylococcal or streptococcal.
