Abstract

DURAN ALVAREZ, Sandalio. Therapeutic challenges in the idiopathic nephrotic syndrome. Rev Cubana Pediatr [online]. 2020, vol.92, n.4, e1082.  Epub Dec 01, 2020. ISSN 0034-7531.

Diagnosis, evaluation and treatment of nephrotic syndrome in children dates from Hypocrate times. However, nowadays some patients with this disease are still a therapeutic challenge for physicians. The aim of this work is to search in recent literature different proposals or treatment protocols, and new drugs that can be used in the care of patients with this disease. Treatment protocols vary with relative frequency and drugs, as well as in frequent relapsing nephrotic, corticodependent or corticoresistant syndromes, do not guarantee in many ocassions the cure of the patient. When steroids fail, alkylanting agents, calcineurin depressants, antispreading, monoclonal antibodies and other drugs can be ussed; but there are patients who do not have remission of proteinuria with any of these treatments. Due to their evolutive characteristics, some patients with idiopathic nephrotic syndrome are still a challenge for the physicians who try to avoid its evolution toward the loss of renal function. Although all the advances in the care of children with nephrotic syndrome due to the discover of steroids, antibiotics, diuretics and immunosupressive drugs, nowadays we do not exactly know which is the best treatment for the resistant types of idiopathic nephrotic syndrome in children.

Keywords : frequently relapsing nephrotic syndrome; corticodependent and corticoresistant; cyclophosphamide; ciclosporin; mycophelonate mofetil; monoclonal antibodies.

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