Which specialist consultations are beneficial to patients with pediatric nephrotic syndrome?

Updated: Mar 04, 2020
  • Author: Jerome C Lane, MD; Chief Editor: Craig B Langman, MD  more...
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Answer

Because of the complexity of care of INS in all but the simplest of cases, the lack of strong clinical evidence supporting treatment options, and the great deal of experience required in successfully managing these patients, care of the patient with INS should always be performed in consultation with a pediatric nephrologist.

In cases that have initially been managed by the primary care specialist, referral to a pediatric nephrologist is mandatory in cases of FRNS, SDNS, SRNS, secondary nephrotic syndrome, and situations in which a kidney biopsy is necessary.

Referral to a pediatric nephrologist is mandatory for all children with nephrotic syndrome whose symptoms fail to respond to initial therapy (complete remission of proteinuria); in most of these patients, a percutaneous renal biopsy is indicated, and an alternative treatment plan may be desirable.

As with all chronic illnesses, many psychosocial issues may need to be addressed, including behavior, adherence to medication, adequate parental/caretaker supervision, medical insurance, missed work and school due to hospitalizations and outpatient visits, and many other important issues. Consultation with social workers and mental health care workers may be useful.


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