Current opinion in pediatrics
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Curr. Opin. Pediatr. · Apr 2008
ReviewEvaluation and management of steroid-unresponsive nephrotic syndrome.
Idiopathic nephrotic syndrome in children is commonly associated with minimal change disease and response to steroid therapy. Steroid-unresponsive nephrotic syndrome is often characterized by persistent proteinuria and progression to chronic kidney disease. Focal segmental glomerulosclerosis is the leading cause of steroid-unresponsive nephrotic syndrome in childhood. There is no uniformed consensus as to the treatment of steroid-unresponsive nephrotic syndrome. Advances in the pathogenesis, genetics and biomarkers or surrogate markers may be useful for the diagnosis and identification of patients with steroid-unresponsive nephrotic syndrome, severity of disease, progression and response to therapy. ⋯ Recent studies in both children and adults have shown an increase in the incidence of focal segmental sclerosis as a cause of steroid-unresponsive nephrotic syndrome. Advances in the pathogenesis and noninvasive methods of diagnosis may allow for the identification of steroid-responsive patients.
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Curr. Opin. Pediatr. · Apr 2008
ReviewContinuous positive airway pressure: scientific and clinical rationale.
To present recent data on the role of noninvasive ventilation in the respiratory management of newborn infants. ⋯ Noninvasive ventilation has partially fulfilled its promise as a gentler alternative to ventilation via an endotracheal tube. Appropriately designed randomized clinical trials are required to determine the best nasal interfaces and pressure generators.
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Curr. Opin. Pediatr. · Apr 2008
ReviewEvaluation and management of steroid-sensitive nephrotic syndrome.
This review examines new literature published in 2006 and 2007 on steroid-sensitive nephrotic syndrome. ⋯ Progress has been made towards elucidating the cause of steroid-sensitive nephrotic syndrome. Data from adequately powered randomized controlled trials are still required to evaluate therapies for frequently relapsing and steroid-dependent steroid-sensitive nephrotic syndrome.