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CLINICAL PRACTICE GUIDELINES
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 48-66

Steroid sensitive nephrotic syndrome: Revised guidelines


1 Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pediatrics, Institute of Child Health, Kolkata, India
3 Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, Delhi, India
4 Department of Pediatrics, Sawai Man Singh Medical College, Jaipur, India
5 Department of Pediatrics, Christian Medical College, Vellore, India
6 Department of Pediatrics, Trivandrum Medical College, Thiruvananthapuram, India
7 Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
8 Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

Correspondence Address:
Arvind Bagga
Department of Pediatrics, Division of Nephrology, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajpn.ajpn_34_21

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Justification: Steroid-sensitive nephrotic syndrome (SSNS) is one of the most common chronic kidney diseases in children. These guidelines update the existing Indian Society of Pediatric Nephrology recommendations on its management. Objective: To frame revised guidelines on diagnosis, evaluation, management, and supportive care of patients with the illness. Process: The guidelines combine evidence-based recommendations and expert opinion. Formulation of key questions was followed by review of literature and evaluation of evidence by experts in two face-to-face meetings. Recommendations: The initial statements provide advice for evaluation at onset and follow-up and indications for kidney biopsy. Subsequent statements provide recommendations for the management of the first episode of illness and of disease relapses. Recommendations on the use of immunosuppressive strategies in patients with frequent relapses and steroid dependence are accompanied by suggestions for step-wise approach and plan of monitoring. Guidance is also provided regarding the management of common complications including edema, hypovolemia, and serious infections. Advice on immunization and transition of care is given. The revised guideline is intended to improve the management and outcomes of patients with SSNS and provide directions for future research.


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