Vol 15, No 1 (2022)
Guidelines / Expert consensus
Published online: 2022-03-31

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The Polish Society for Pediatric Nephrology (PTNFD) recommendations on the management of children with nephrotic syndrome

Maria Szczepańska1, Irena Bałasz-Chmielewska2, Ryszard Grenda3, Kinga Musiał4, Iwona Ogarek5, Małgorzata Pańczyk-Tomaszewska6, Jacek Zachwieja7, Aleksandra Żurowska2
DOI: 10.5603/RDTF.2022.0001
Renal Disease and Transplantation Forum 2022;15(1):36-57.

Abstract

On behalf of the Polish Society for Pediatric Nephrology, a group of experts has upgraded the previously announced recommendations* on the management of children with nephrotic syndrome. Recommendations are based on the published European and American guidelines, the results of reliable trials and meta-analyses, as well as local experience. They should be regarded as advisory for pediatricians in their personal experience-driven choice of the optimal available strategy for the diagnostics and treatment of individual pediatric NS patients. The recommendations will be re-updated by the Society in the forthcoming years to account for the continued rapid progress of clinical research and knowledge in the field of glomerulonephritis.  

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References

  1. Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for Glomerulonephritis. Kidney Int. ; 2(Suppl. 2012): 139–274.
  2. Rovin BH, Caster DJ, Cattran DC, et al. Conference Participants. Management and treatment of glomerular diseases (part 2): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019; 95(2): 281–295.
  3. Beck L, Bomback AS, Choi MJ, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis. Am J Kidney Dis. 2013; 62(3): 403–441.
  4. Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for Glomerulonephritis. Kidney Int. 2020; 2: 153–176.
  5. Lombel RM, Gipson DS, Hodson EM, et al. Kidney Disease: Improving Global Outcomes. Treatment of steroid-sensitive nephrotic syndrome: new guidelines from KDIGO. Pediatr Nephrol. 2013; 28(3): 415–426.
  6. Lombel RM, Gipson DS, Hodson EM, et al. Kidney Disease: Improving Global Outcomes, Kidney Disease: Improving Global Outcomes. Treatment of steroid-resistant nephrotic syndrome in children: new guidelines from KDIGO. Pediatr Nephrol. 2013; 28(3): 409–414.
  7. Nephrotic syndrome in children: prediction of histopathology from clinical and laboratory characteristics at time of diagnosis. A report of the International Study of Kidney Disease in Children. Kidney Int. 1978; 13(2): 159–165.
  8. Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet. 2003; 362(9384): 629–639.
  9. Bierzynska A, Soderquest K, Koziell A. Genes and podocytes - new insights into mechanisms of podocytopathy. Front Endocrinol (Lausanne). 2014; 5: 226.
  10. Varner JD, Chryst-Stangl M, Esezobor CI, et al. Genetic testing for steroid-resistant-nephrotic syndrome in an outbred population. Front Pediatr. 2018; 6: 307.
  11. Trautmann A, Bodria M, Ozaltin F, et al. PodoNet Consortium. Spectrum of steroid-resistant and congenital nephrotic syndrome in children: the PodoNet registry cohort. Clin J Am Soc Nephrol. 2015; 10(4): 592–600.
  12. Abramowicz M, Barnett HL, Edelmann CM, et al. Controlled trial of azathioprine in children with nephrotic syndrome. A report for the international study of kidney disease in children. The Lancet. 1970; 295(7654): 959–961.
  13. Feber J, Al-Matrafi J, Farhadi E, et al. Prednisone dosing per body weight or body surface area in children with nephrotic syndrome: is it equivalent? Pediatr Nephrol. 2009; 24(5): 1027–1031.
  14. Saadeh SA, Baracco R, Jain A, et al. Weight or body surface area dosing of steroids in nephrotic syndrome: is there an outcome difference? Pediatr Nephrol. 2011; 26(12): 2167–2171.
  15. Ekka BK, Bagga A, Srivastava RN. Single- versus divided-dose prednisolone therapy for relapses of nephrotic syndrome. Pediatr Nephrol. 1997; 11(5): 597–599.
  16. Hodson EM, Willis NS, Craig JC. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev. 2007(4): CD001533.
  17. Ueda N, Chihara M, Kawaguchi S, et al. Intermittent versus long-term tapering prednisolone for initial therapy in children with idiopathic nephrotic syndrome. J Pediatr. 1988; 112(1): 122–126.
  18. Ehrich JH, Brodehl J, Brodehl J, et al. The treatment of minimal change nephrotic syndrome (lipoid nephrosis): cooperative studies of the Arbeitsgemeinschaft für Pädiatrische Nephrologie (APN). Klin Padiatr. 1982; 194(3): 162–165.
  19. Ksiazek J, Wyszyńska T. Short versus long initial prednisone treatment in steroid-sensitive nephrotic syndrome in children. Acta Paediatr. 1995; 84(8): 889–893.
  20. Bagga A, Hari P, Srivastava RN. Prolonged versus standard prednisolone therapy for initial episode of nephrotic syndrome. Pediatr Nephrol. 1999; 13(9): 824–827.
  21. Hiraoka M, Tsukahara H, Matsubara K, et al. A randomized study of two long-course prednisolone regimens for nephrotic syndrome in children. American Journal of Kidney Diseases. 2003; 41(6): 1155–1162.
  22. Lombel RM, Gipson DS, Hodson EM, et al. Kidney Disease: Improving Global Outcomes. Treatment of steroid-sensitive nephrotic syndrome: new guidelines from KDIGO. Pediatr Nephrol. 2013; 28(3): 415–426.
  23. Ziółkowska H, Bałasz-Chmielewska I, Grenda R, et al. Zalecenia Polskiego Towarzystwa Nefrologii Dziecięcej (PTNFD) dotyczące postępowania z dzieckiem z zespołem nerczycowym. Forum Nefrol. 2015; 8: 238–256.
  24. Teeninga N, Kist-van Holthe JE, van Rijswijk N, et al. Extending prednisolone treatment does not reduce relapses in childhood nephrotic syndrome. J Am Soc Nephrol. 2013; 24(1): 149–159.
  25. Sinha A, Saha A, Kumar M, et al. Extending initial prednisolone treatment in a randomized control trial from 3 to 6 months did not significantly influence the course of illness in children with steroid-sensitive nephrotic syndrome. Kidney Int. 2015; 87(1): 217–224.
  26. Yoshikawa N, Nakanishi K, Sako M, et al. Japanese Study Group of Kidney Disease in Children. A multicenter randomized trial indicates initial prednisolone treatment for childhood nephrotic syndrome for two months is not inferior to six-month treatment. Kidney Int. 2015; 87(1): 225–232.
  27. Hahn D, Hodson EM, Willis NS, et al. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev. 2015(3): CD001533.
  28. Hodson EM, Hahn D, Craig JC. Corticosteroids for the initial episode of steroid-sensitive nephrotic syndrome. Pediatr Nephrol. 2015; 30(7): 1043–1046.
  29. Couderc A, Bérard E, Guigonis V, et al. [Treatments of steroid-dependent nephrotic syndrome in children]. Arch Pediatr. 2017; 24(12): 1312–1320.
  30. Pasini A, Benetti E, Conti G, et al. The Italian Society for Pediatric Nephrology (SINePe) consensus document on the management of nephrotic syndrome in children: Part I - Diagnosis and treatment of the first episode and the first relapse. Ital J Pediatr. 2017; 43(1): 41.
  31. Ramachandran R, Jha V. Integration with Kidney Disease Improving Global Outcomes (KDIGO). Glomerulonephritis. 2019: 87–95.
  32. Webb NJa, Woolley RL, Lambe T, et al. Sixteen-week versus standard eight-week prednisolone therapy for childhood nephrotic syndrome: the PREDNOS RCT. Health Technol Assess. 2019; 23(26): 1–108.
  33. Hahn D, Hodson EM, Willis NS, et al. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev. 2015; 30(3): CD001533–1046.
  34. Nephrotic syndrome in children: A randomized trial comparing two prednisone regimens in steroid-responsive patients who relapse early. The Journal of Pediatrics. 1979; 95(2): 228–233.
  35. Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for Glomerulonephritis. Kidney Int. Suppl. 2020; 2: 153–176.
  36. Alternate-day prednisone is more effective than intermittent prednisone in frequently relapsing nephrotic syndrome. A report of "Arbeitsgemeinschaft für Pädiatrische Nephrologie. Eur J Pediatr. 1981; 135(3): 229–237.
  37. MacDonald NE, Wolfish N, McLaine P, et al. Role of respiratory viruses in exacerbations of primary nephrotic syndrome. J Pediatr. 1986; 108(3): 378–382.
  38. Mattoo TK, Mahmoud MA. Increased maintenance corticosteroids during upper respiratory infection decrease the risk of relapse in nephrotic syndrome. Nephron. 2000; 85(4): 343–345.
  39. Abeyagunawardena AS, Thalgahagoda RS, Dissanayake PV, et al. Short courses of daily prednisolone during upper respiratory tract infections reduce relapse frequency in childhood nephrotic syndrome. Pediatr Nephrol. 2017; 32(8): 1377–1382.
  40. Gulati A, Sinha A, Sreenivas V, et al. Daily corticosteroids reduce infection-associated relapses in frequently relapsing nephrotic syndrome: a randomized controlled trial. Clin J Am Soc Nephrol. 2011; 6(1): 63–69.
  41. Webb N, Frew E, Brettell E, et al. Short course daily prednisolone therapy during an upper respiratory tract infection in children with relapsing steroid-sensitive nephrotic syndrome (PREDNOS 2): protocol for a randomised controlled trial. Trials. 2014; 15(1).
  42. Lombel RM, Gipson DS, Hodson EM, et al. Kidney Disease: Improving Global Outcomes. Treatment of steroid-sensitive nephrotic syndrome: new guidelines from KDIGO. Pediatr Nephrol. 2013; 28(3): 415–426.
  43. Nakanishi K, Iijima K, Ishikura K, et al. Japanese Study Group of Renal Disease in Children. Two-year outcome of the ISKDC regimen and frequent-relapsing risk in children with idiopathic nephrotic syndrome. Clin J Am Soc Nephrol. 2013; 8(5): 756–762.
  44. Hodson EM, Knight JF, Willis NS, et al. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev. 2000(4): CD001533.
  45. Gulati A, Sinha A, Sreenivas V, et al. Daily corticosteroids reduce infection-associated relapses in frequently relapsing nephrotic syndrome: a randomized controlled trial. Clin J Am Soc Nephrol. 2011; 6(1): 63–69.
  46. Webb NJ, Frew E, Brettell EA, et al. for PREDNOS 2 study group. Trials. 2014; 15: 147.
  47. Hahn D, Hodson EM, Willis NS, et al. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev. 2015; 30(3): CD001533–1046.
  48. Hodson EM, Willis NS, Craig JC. Non-corticosteroid treatment for nephrotic syndrome in children. Cochrane Database Syst Rev. 2008(1): CD002290.
  49. Ishikura K, Ikeda M, Hattori S, et al. Effective and safe treatment with cyclosporine in nephrotic children: a prospective, randomized multicenter trial. Kidney Int. 2008; 73(10): 1167–1173.
  50. Niaudet P. Comparison of cyclosporin and chlorambucil in the treatment of steroid-dependent idiopathic nephrotic syndrome: a multicentre randomized controlled trial. The French Society of Paediatric Nephrology. Pediatr Nephrol. 1992; 6(1): 1–3.
  51. Ponticelli C, Edefonti A, Ghio L, et al. Cyclosporin versus cyclophosphamide for patients with steroid-dependent and frequently relapsing idiopathic nephrotic syndrome: a multicentre randomized controlled trial. Nephrol Dial Transplant. 1993; 8(12): 1326–1332.
  52. Cammas B, Harambat J, Bertholet-Thomas A, et al. Long-effects of cyclophosphamide therapy in steroid-dependent and frequently relapsing idiopathic nephrotic syndrome. Nephrol Dial Transplant. 2011; 26: 178–184.
  53. Latta K, von Schnakenburg C, Ehrich JH. A meta-analysis of cytotoxic treatment for frequently relapsing nephrotic syndrome in children. Pediatr Nephrol. 2001; 16(3): 271–282.
  54. Dorresteijn EM, Kist-van Holthe JE, Levtchenko EN, et al. Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome. Pediatr Nephrol. 2008; 23(11): 2013–2020.
  55. Gellerman J, Querfeld U. Frequently relapsing steroid-sensitive nephrotic syndrome (SSNS) in children and adolescents: treatment with mycophenolate mofetil (MMF) vs cyclosporine (CsA). Pediatr Nephrol. 2011; 26: 1579–1582.
  56. Fujinaga S, Ohtomo Y, Umino D, et al. A prospective study on the use of mycophenolate mofetil in children with cyclosporine-dependent nephrotic syndrome. Pediatr Nephrol. 2007; 22(1): 71–76.
  57. Kirpalani A, Rothfels L, Sharma AP, et al. Nephrotic state substantially enhances apparent mycophenolic acid clearance
. Clin Nephrol. 2019; 91(3): 162–171.
  58. Hackl Á, Cseprekál O, Gessner M, et al. Mycophenolate mofetil therapy in children with idiopathic nephrotic syndrome: does therapeutic drug monitoring make a difference? Ther Drug Monit. 2016; 38(2): 274–279.
  59. Guigonis V, Dallocchio A, Baudouin V, et al. Rituximab treatment for severe steroid- or cyclosporine-dependent nephrotic syndrome: a multicentric series of 22 cases. Pediatr Nephrol. 2008; 23(8): 1269–1279.
  60. Ravani P, Rossi R, Bonanni A, et al. Rituximab in children with steroid-dependent nephrotic syndrome: a multicenter, open-label, noninferiority, randomized controlled trial. J Am Soc Nephrol. 2015; 26(9): 2259–2266.
  61. Sellier-Leclerc AL, Baudouin V, Kwon T, et al. Rituximab in steroid-dependent idiopathic nephrotic syndrome in childhood--follow-up after CD19 recovery. Nephrol Dial Transplant. 2012; 27(3): 1083–1089.
  62. Lombel RM, Gipson DS, Hodson EM, et al. Kidney Disease: Improving Global Outcomes. Treatment of steroid-sensitive nephrotic syndrome: new guidelines from KDIGO. Pediatr Nephrol. 2013; 28(3): 415–426.
  63. Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for Glomerulonephritis. Kidney Int. Suppl. 2020; 2: 153–176.
  64. Chan EYH, Tullus K. Rituximab in children with steroid sensitive nephrotic syndrome: in quest of the optimal regimen. Pediatr Nephrol. 2021; 36(6): 1397–1405.
  65. Larkins NG, Liu ID, Willis NS, et al. Non-corticosteroid immunosuppressive medications for steroid-sensitive nephrotic syndrome in children. Cochrane Database Syst Rev. 2020; 4: CD002290.
  66. Sadowski CE, Lovric S, Ashraf S, et al. SRNS Study Group. A single-gene cause in 29.5% of cases of steroid-resistant nephrotic syndrome. J Am Soc Nephrol. 2015; 26(6): 1279–1289.
  67. Santín S, Bullich G, Tazón-Vega B, et al. Clinical utility of genetic testing in children and adults with steroid-resistant nephrotic syndrome. Clin J Am Soc Nephrol. 2011; 6(5): 1139–1148.
  68. Ponticelli C, Rizzoni G, Edefonti A, et al. A randomized trial of cyclosporine in steroid-resistant idiopathic nephrotic syndrome. Kidney Int. 1993; 43(6): 1377–1384.
  69. Bagga A, Mudigoudar BD, Hari P, et al. Enalapril dosage in steroid-resistant nephrotic syndrome. Pediatr Nephrol. 2004; 19(1): 45–50.
  70. Trautmann A, Bodria M, Ozaltin F, et al. PodoNet Consortium. Spectrum of steroid-resistant and congenital nephrotic syndrome in children: the PodoNet registry cohort. Clin J Am Soc Nephrol. 2015; 10(4): 592–600.
  71. Shenoy M, Plant ND, Lewis MA, et al. Intravenous methylprednisolone in idiopathic childhood nephrotic syndrome. Pediatr Nephrol. 2010; 25(5): 899–903.
  72. Lieberman KV, Tejani A. A randomized double-blind placebo-controlled trial of cyclosporine in steroid-resistant idiopathic focal segmental glomerulosclerosis in children. J Am Soc Nephrol. 1996; 7(1): 56–63.
  73. Choudhry S, Bagga A, Hari P, et al. Efficacy and safety of tacrolimus versus cyclosporine in children with steroid-resistant nephrotic syndrome: a randomized controlled trial. Am J Kidney Dis. 2009; 53(5): 760–769.
  74. de Mello VR, Rodrigues MT, Mastrocinque TH, et al. Mycophenolate mofetil in children with steroid/cyclophosphamide-resistant nephrotic syndrome. Pediatr Nephrol. 2010; 25(3): 453–460.
  75. Gellermann J, Ehrich JHH, Querfeld U. Sequential maintenance therapy with cyclosporin A and mycophenolate mofetil for sustained remission of childhood steroid-resistant nephrotic syndrome. Nephrol Dial Transplant. 2012; 27(5): 1970–1978.
  76. Prytuła A, Iijima K, Kamei K, et al. Rituximab in refractory nephrotic syndrome. Pediatr Nephrol. 2010; 25(3): 461–468.
  77. Tarshish P, Tobin JN, Bernstein J, et al. Cyclophosphamide does not benefit patients with focal segmental glomerulosclerosis. A report of the International Study of Kidney Disease in Children. Pediatr Nephrol. 1996; 10(5): 590–593.
  78. Elhence R, Gulati S, Kher V, et al. Intravenous pulse cyclophosphamide--a new regime for steroid-resistant minimal change nephrotic syndrome. Pediatr Nephrol. 1994; 8(1): 1–3.
  79. Lombel RM, Gipson DS, Hodson EM, et al. Kidney Disease: Improving Global Outcomes, Kidney Disease: Improving Global Outcomes. Treatment of steroid-resistant nephrotic syndrome in children: new guidelines from KDIGO. Pediatr Nephrol. 2013; 28(3): 409–414.
  80. Tarshish P, Tobin JN, Bernstein J, et al. Cyclophosphamide does not benefit patients with focal segmental glomerulosclerosis. A report of the International Study of Kidney Disease in Children. Pediatr Nephrol. 1996; 10(5): 590–593.
  81. Jellouli M, Charfi R, Maalej B, et al. Rituximab in the management of pediatric steroid-resistant nephrotic syndrome: A systematic review. J Pediatr. 2018; 197: 191–197.e1.
  82. Hackl Á, Cseprekál O, Gessner M, et al. Mycophenolate mofetil therapy in children with idiopathic nephrotic syndrome: Does therapeutic drug monitoring make a difference? Ther Drug Monit. 2016; 38(2): 274–279.
  83. Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for Glomerulonephritis, Kidney Int. Suppl. ; 2: 153–176.
  84. Trautmann A, Vivarelli M, Samuel S, et al. International Pediatric Nephrology Association. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome. Pediatr Nephrol. 2020; 35(8): 1529–1561.
  85. Wyszyńska T, Litwin M, Książek J, Borowski A, Jarmoliński T. Zespół nerczycowy [Nephrotic syndrome]. [In:] Sieniawska M., (Eds). Nefrologia dziecięca, t. I. Ośrodek Informacji Naukowej „Polfa” Sp. z o.o. In: Wyszyńska T, Litwin M, Książek J, Borowski A, Jarmoliński T. ed. Nefrologia dziecięca, t. I. Ośrodek Informacji Naukowej „Polfa” Sp. z o.o., Warszawa 2003.
  86. Grenda R, Pańczyk-Tomaszewska M, Ziółkowska H. Choroby kłębuszków nerkowych [Renal glomerular diseases]. In: Kawalec W, Grenda R, Kulus M. ed. Pediatria, t. I. PZWL, Warszawa 2008.
  87. Cadnapaphornchai MA, Tkachenko O, Shchekochikhin D, et al. The nephrotic syndrome: pathogenesis and treatment of edema formation and secondary complications. Pediatr Nephrol. 2014; 29(7): 1159–1167.
  88. Bockenhauer D. Over- or underfill: not all nephrotic states are created equal. Pediatr Nephrol. 2013; 28(8): 1153–1156.
  89. Ellis D. Pathophysiology, evaluation, and management of edema in childhood nephrotic syndrome. Front Pediatr. 2015; 3: 111.
  90. Kallash M, Mahan JD. Mechanisms and management of edema in pediatric nephrotic syndrome. Pediatr Nephrol. 2021; 36(7): 1719–1730.
  91. Kitsios GD, Mascari P, Ettunsi R, et al. Co-administration of furosemide with albumin for overcoming diuretic resistance in patients with hypoalbuminemia: a meta-analysis. J Crit Care. 2014; 29(2): 253–259.
  92. Pasini A, Benetti E, Conti G, et al. The Italian Society for Pediatric Nephrology (SINePe) consensus document on the management of nephrotic syndrome in children: Part I - Diagnosis and treatment of the first episode and the first relapse. Ital J Pediatr. 2017; 43(1): 41.
  93. Keenswijk W, Ilias MI, Raes A, et al. Urinary potassium to urinary potassium plus sodium ratio can accurately identify hypovolemia in nephrotic syndrome: a provisional study. Eur J Pediatr. 2018; 177(1): 79–84.
  94. Kerlin BA, Blatt NB, Fuh B, et al. Epidemiology and risk factors for thromboembolic complications of childhood nephrotic syndrome: a Midwest Pediatric Nephrology Consortium (MWPNC) study. J Pediatr. 2009; 155(1): 105–10, 110.e1.
  95. Bauman M, Massicotte MP, Yiu V. Disordered hemostasis and renal disorders. In: Geary DF, Schaefe F. ed. Comprehensive pediatric nephrology. Mosby 2008: 385–394.
  96. KDIGO General principles in the management of glomerular disease. Kidney Int. Suppl. 2012; 2: 156–162.
  97. Zaffanello M, Franchini M. Thromboembolism in childhood nephrotic syndrome: a rare but serious complication. Hematology. 2007; 12(1): 69–73.
  98. Ziółkowska H. Zespół nerczycowy. Pediatr Dypl. 2013; 17: 17–28.
  99. Lilova MI, Velkovski IG, Topalov IB. Thromboembolic complications in children with nephrotic syndrome in Bulgaria (1974-1996). Pediatr Nephrol. 2000; 15(1-2): 74–78.
  100. Glassock RJ. Prophylactic anticoagulation in nephrotic syndrome: a clinical conundrum. J Am Soc Nephrol. 2007; 18(8): 2221–2225.
  101. Grenda R, Ziółkowska H. Choroby układu moczowego. In: Kawalec W, Grenda R, Ziółkowska H. ed. Pediatria. PZWL, Warszawa 2013: 657–740.
  102. Park SeJ, Shin JIl. Complications of nephrotic syndrome. Korean J Pediatr. 2011; 54(8): 322–328.
  103. Yang GF, Schoepf UJ, Zhu H, et al. Thromboembolic complications in nephrotic syndrome: imaging spectrum. Acta Radiol. 2012; 53(10): 1186–1194.
  104. Kerlin BA, Haworth K, Smoyer WE. Venous thromboembolism in pediatric nephrotic syndrome. Pediatr Nephrol. 2014; 29(6): 989–997.
  105. Suri D, Ahluwalia J, Saxena AK, et al. Thromboembolic complications in childhood nephrotic syndrome: a clinical profile. Clin Exp Nephrol. 2014; 18(5): 803–813.
  106. Monagle P, Chan AKC, Goldenberg NA, et al. Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2 Suppl): e737S–e801S.
  107. Wright JM, Watts RG. Venous thromboembolism in pediatric patients: epidemiologic data from a pediatric tertiary care center in Alabama. J Pediatr Hematol Oncol. 2011; 33(4): 261–264.
  108. Pasini A, Benetti E, Conti G, et al. The Italian Society for Pediatric Nephrology (SINePe) consensus document on the management of nephrotic syndrome in children: Part I - Diagnosis and treatment of the first episode and the first relapse. Ital J Pediatr. 2017; 43(1): 41.
  109. Carpenter SL, Goldman J, Sherman AK, et al. Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome. Pediatr Nephrol. 2019; 34(2): 261–267.
  110. Prescott WA, Streetman DaD, Streetman DS. The potential role of HMG-CoA reductase inhibitors in pediatric nephrotic syndrome. Ann Pharmacother. 2004; 38(12): 2105–2114.
  111. Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet. 2003; 362(9384): 629–639.
  112. Saland JM, Ginsberg H, Fisher EA. Dyslipidemia in pediatric renal disease: epidemiology, pathophysiology, and management. Curr Opin Pediatr. 2002; 14(2): 197–204.
  113. Gipson DS, Massengill SF, Yao L, et al. Management of childhood onset nephrotic syndrome. Pediatrics. 2009; 124(2): 747–757.
  114. Avis HJ, Hutten BA, Gagné C, et al. Efficacy and safety of rosuvastatin therapy for children with familial hypercholesterolemia. J Am Coll Cardiol. 2010; 55(11): 1121–1126.
  115. de Jongh S, Ose L, Szamosi T, et al. Simvastatin in Children Study Group. Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized, double-blind, placebo-controlled trial with simvastatin. Circulation. 2002; 106(17): 2231–2237.
  116. Knipscheer HC, Boelen CC, Kastelein JJ, et al. Short-term efficacy and safety of pravastatin in 72 children with familial hypercholesterolemia. Pediatr Res. 1996; 39(5): 867–871.
  117. McCrindle BW, Helden E, Cullen-Dean G, et al. A randomized crossover trial of combination pharmacologic therapy in children with familial hyperlipidemia. Pediatr Res. 2002; 51(6): 715–721.
  118. McCrindle BW, Ose L, Marais AD. Efficacy and safety of atorvastatin in children and adolescents with familial hypercholesterolemia or severe hyperlipidemia: a multicenter, randomized, placebo-controlled trial. J Pediatr. 2003; 143(1): 74–80.
  119. Stein EA, Illingworth DR, Kwiterovich PO, et al. Efficacy and safety of lovastatin in adolescent males with heterozygous familial hypercholesterolemia: a randomized controlled trial. JAMA. 1999; 281(2): 137–144.
  120. Chapter 4: Pharmacological cholesterol-lowering treatment in children. Kidney Int Suppl (2011). 2013; 3(3): 282–283.
  121. Dogra GK, Watts GF, Herrmann S, et al. Statin therapy improves brachial artery endothelial function in nephrotic syndrome. Kidney Int. 2002; 62(2): 550–557.
  122. Belay B, Belamarich PF, Tom-Revzon C. The use of statins in pediatrics: knowledge base, limitations, and future directions. Pediatrics. 2007; 119(2): 370–380.
  123. Noone D, Iijima K, Parekh R. Idiopathic nephrotic syndrome in children. The Lancet. 2018; 392(10141): 61–74.
  124. Banerjee S, Basu S, Sengupta J. Vitamin D in nephrotic syndrome remission: a case-control study. Pediatr Nephrol. 2013; 28(10): 1983–1989.
  125. Weng FL, Shults J, Herskovitz RM, et al. Vitamin D insufficiency in steroid-sensitive nephrotic syndrome in remission. Pediatr Nephrol. 2005; 20(1): 56–63.
  126. Mittal SK, Dash SC, Tiwari SC, et al. Bone histology in patients with nephrotic syndrome and normal renal function. Kidney Int. 1999; 55(5): 1912–1919.
  127. Freundlich M, Jofe M, Goodman WG, et al. Bone histology in steroid-treated children with non-azotemic nephrotic syndrome. Pediatr Nephrol. 2004; 19(4): 400–407.
  128. Gulati S, Godbole M, Singh U, et al. Are children with idiopathic nephrotic syndrome at risk for metabolic bone disease? American Journal of Kidney Diseases. 2003; 41(6): 1163–1169.
  129. Choudhary S, Agarwal I, Seshadri MS. Calcium and vitamin D for osteoprotection in children with new-onset nephrotic syndrome treated with steroids: a prospective, randomized, controlled, interventional study. Pediatr Nephrol. 2014; 29(6): 1025–1032.
  130. Banerjee S, Basu S, Sen A, et al. The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome. Pediatr Nephrol. 2017; 32(11): 2063–2070.
  131. Yadav VK, Sharma S, Debata PK, et al. Change in bone mineral density and role of vitamin D and calcium supplementation during treatment of first episode nephrotic syndrome. J Clin Diagn Res. 2017; 11(9): SC18–SC21.
  132. Selewski DT, Chen A, Shatat IF, et al. Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study. Pediatr Nephrol. 2016; 31(3): 465–472.
  133. Emma F, Sesto A, Rizzoni G. Long-term linear growth of children with severe steroid-responsive nephrotic syndrome. Pediatr Nephrol. 2003; 18(8): 783–788.
  134. Donatti TL, Koch VH, Fujimura MD, et al. Growth in steroid-responsive nephrotic syndrome: a study of 85 pediatric patients. Pediatr Nephrol. 2003; 18(8): 789–795.
  135. Elzouki AY, Jaiswal OP. Long-term, small dose prednisone therapy in frequently relapsing nephrotic syndrome of childhood. Effect on remission, statural growth, obesity, and infection rate. Clin Pediatr (Phila). 1988; 27(8): 387–392.
  136. Jabs K, Sullivan EK, Avner ED, et al. Alternate-day steroid dosing improves growth without adversely affecting graft survival or long-term graft function. A report of the North American Pediatric Renal Transplant Cooperative Study. Transplantation. 1996; 61(1): 31–36.
  137. Chapter 3: Steroid-sensitive nephrotic syndrome in children. Kidney Int Suppl (2011). 2012; 2(2): 163–171.
  138. Czajka H, Wysocki J. Szczepienia w profilaktyce chorób zakaźnych. Vademecum. Helpmed, Kraków 2010.
  139. Rubik J. Szczepienia u pacjentów nefrologicznych — kiedy i jakie szczepionki są konieczne? Klinika Pediatryczna. 2008; 16: 350–353.
  140. Komunikat Głównego Inspektora Sanitarnego z dnia 31 października 2017 r. w sprawie Programu Szczepień Ochronnych na rok 2018. Dziennik Urzędowy Ministra Zdrowia, poz. 108 z 31 października 2017 r.
  141. Immunisation guideline for children with chronic kidney disease. Renal Unit Royal Hospital for Sick Children Yorkhill Division, Nov. 2011;. https://www.clinicalguidelines.scot.nhs.uk/nhsggc-paediatric-clinical-guidelines/nhsggc-guidelines/kidney-diseases/immunisation-guideline-for-children-with-chronic-kidney-disease/.
  142. Nuorti JP, Whitney CG. Centers for Disease Control and Prevention (CDC). Prevention of pneumococcal disease among infants and children - use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine - recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010; 59(RR-11): 1–18.
  143. https://publications.aap.org/redbook.
  144. http://www.cdc.gov/vaccines/schedules/hcp/index.html.
  145. Alpay H, Yildiz N, Onar A, et al. Varicella vaccination in children with steroid-sensitive nephrotic syndrome. Pediatr Nephrol. 2002; 17(3): 181–183.
  146. Poyrazoğlu HM, Düşünsel R, Gündüz Z, et al. Antibody response to influenza A vaccination in children with nephrotic syndrome. Pediatr Nephrol. 2004; 19(1): 57–60.
  147. Ulinski T, Leroy S, Dubrel M, et al. High serological response to pneumococcal vaccine in nephrotic children at disease onset on high-dose prednisone. Pediatr Nephrol. 2008; 23(7): 1107–1113.
  148. Immunisation of the immunocompromised child. Best Practice Statement. February 2002. Royal College of Paediatrics and Child Healt. http://rcpch.adlibhosting.com/files/Immunisation%20of%20the%20Immunocompromised%20Child%C2%A02002-02.pdf..
  149. Janus N, Vacher LV, Karie S, et al. Vaccination and chronic kidney disease. Nephrol Dial Transplant. 2008; 23(3): 800–807.
  150. Kamei K, Miyairi I, Ishikura K, et al. Prospective study of live attenuated vaccines for patients with nephrotic syndrome receiving immunosuppressive agents. J Pediatr. 2018; 196: 217–222.e1.



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