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REVIEW ARTICLE
Korean J Pediatr 2011 August;54(8) :322-328.
doi:https://doi.org/10.3345/kjp.2011.54.8.322
Complications of nephrotic syndrome
Se Jin Park (Park SJ)1, Jae Il Shin (Shin JI)2
1Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
2The Institute of Kidney Disease, Department of Pediatrics, Severance Childrens Hospital, Yonsei University College of Medicine, Seoul, Korea
Corresponding Author: Jae Il Shin ,Tel: +82-2-2228-2050, Fax: +82-2-393-9118, Email: shinji@yuhs.ac
Copyright © 2011 by The Korean Pediatric Society
ABSTRACT
Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.
Keywords: Nephrotic syndrome | Complications | Proteinuria | Child
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