In this section
Nephrotic Syndrome usually presents with the classic triad of oedema, proteinuria and hypoalbuminaemia.
Oedema can be non-dependant eg periorbital. Consider other causes of generalised oedema eg liver disease, congestive cardiac failure and protein losing enteropathy.
The diagnosis of nephrotic syndrome includes:
1. Admit to hospital on first presentation
2. If the child is profoundly ill or appears to have sepsis treat
3. Manage oedema
5. Prophylaxis against complications
A relapse is defined as proteinuria 3+ or 4+ for 3 consecutive days, and should prompt re-introduction of full dose prednisolone:
The total time of weaning regimen can be shortened if the child relapses infrequently (2–3 relapses in any 12-month period) and responds to treatment quickly
If oedema recurs, penicillin prophylaxis should also be restarted (see dosing above)
Discuss with nephrology if:
Child requiring care beyond the comfort of the local health care facility
For emergency advice and paediatric or neonatal ICU transfers, see Retrieval Services.
Nephrotic Syndrome Parent Information Diary for entering protein level
Last updated November 2019