Hi Guys!
Hello friends this is your friendly neighborhood pediatrician doctor at and as we discussed uh before about uh nephrotic syndrome that uh the basics and the definitions of the disease now we’ll uh go towards the management so as we uh all know please comment down below that what is the most common cause of nephrotic syndrome in pediatric patients and what is the
Most common cause of nephrotic nephrotic syndrome in adult patients so uh there is a specific treatment protocol for treatment of nephrotic syndrome in pediatric patient if there is it is a first episode of nephrotic syndrome there is uh ideally 12 weeks therapy of prednisone where for six weeks we give daily therapy and for the next six week we give alternate
Day therapy now uh if the patient uh improves we stop the therapy after uh 12 weeks because as you all know that there is a very less chances of recurrence in pediatric patient and those who those of you who have commented down below the most common cause of nephrotic syndrome in pediatric patient is minimal change disease so in minimal change disease there might
Not be prolonged disease so uh we only give for 12 weeks after you complete 12 weeks if the patient is either diagnosed as frequent relapses or steroid dependent as we saw in the definitions then you have to give alternate day steroid therapy for long term up to one year to those patients and the low dose steroid therapy 0.3 to 0.5 mg per kg we have to give for
One year alternate day and if the patient has infections or any stressors then we convert it into a daily therapy now as you all know that there are complications of steroid therapy long term steroid therapy please comment down below a few common complications of steroid therapy so uh because there is a steroid there is low dose steroid there is a minimization of
The complications though there are complications now if there are mul relapses in the patient then we have to shift to other drugs now if the relapse is uncomplicated then we shift the patient to a drug known as levar missile lava missile is anti-parasitic drug and it is given at the dose of two to two point five mg per kg alternate day therapy the side effect of
Level is a granulocytosis and if there is a complicated relapse then we shift the patient to mycophenolate more fatty mycophinolate please uh everyone comment the mechanism of the mycophenolate more fetal the mechanism action of this drug and if there is no improvement then we use cyclosporine acrolimus and if still no response we shift the patient to rituximab
Which is anticd now there is one drug known as cyclophosphamide which is the drug of choice for the patients having steroid resistance for patients having steroid resistance though they prefer giving tacrolimus and cyclosporine before the drug of choice is ideally taken a cycle of phosphormite the dose of cycle of phosphate is same as prednisone 2mg per kg we
Have to give daily but there is uh many uh side effects of cyclophosphamide including hemorrhagic cystitis and other complications of cyclophosphamide is severe bone marrow suppression and gonadal toxicity so this is all for the treatment i hope you like the new style uh if you like this please comment down below and i’ll try to make more videos in this type thank you
Transcribed from video
nephrotic syndrome – management By Dr Aditya Bhatt
