ReviewPediatric nephrology (Berlin, Germany)2018
Difficult-to-treat idiopathic nephrotic syndrome: established drugs, open questions and future options.
Review in Pediatric nephrology (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Interventions for idiopathic steroid-resistant nephrotic syndrome in children.The Cochrane database of systematic reviews · 2025Pooled it
- Interventions for idiopathic steroid-resistant nephrotic syndrome in children.The Cochrane database of systematic reviews · 2019Pooled it
- Steroid response and outcomes in childhood nephrotic syndrome: A multicenter, cross-sectional study from Jordan.World journal of clinical pediatrics · 2025Article
- The role of B lymphocyte subsets in nephrotic syndrome: functions, mechanisms, clinical significance and future perspectives.Frontiers in immunology · 2025Review
- The outcome of rituximab in treating steroid dependent nephrotic syndrome.: Histopathology and immunosuppressive drugs as predicting factors.Saudi medical journal · 2022Article
- Treatment-Associated Side Effects in Patients with Steroid-Dependent Nephrotic Syndrome.Maedica · 2022Article
- Second and Third Generational Advances in Therapies of the Immune-Mediated Kidney Diseases in Children and Adolescents.Children (Basel, Switzerland) · 2022Review
- Intravenous cyclophosphamide induces remission in children with difficult to treat steroid resistant nephrotic syndrome from minimal change disease.BMC nephrology · 2021Article
- Effects of miR-151-3p-mediated GLCCl1 expression on biological function in children with nephrotic syndrome.American journal of translational research · 2021Article
- Editorial: Nephrotic Syndrome in Children.Frontiers in pediatrics · 2021Article
- Ofatumumab treatment for nephrotic syndrome recurrence after pediatric renal transplantation.Pediatric nephrology (Berlin, Germany) · 2020Article
- Ofatumumab rescue treatment in post-transplant recurrence of focal segmental glomerulosclerosis.Pediatric nephrology (Berlin, Germany) · 2020Article
- Chinese Herbal Injections for Primary Nephrotic Syndrome in Adults: A Systematic Review and Network Meta-Analysis.Evidence-based complementary and alternative medicine : eCAM · 2020Article
- Immunosuppressive therapy in children with primary nephrotic syndrome: single center experience, Karachi, Pakistan.BMC nephrology · 2019Article
- Low-dose rituximab is no less effective for nephrotic syndrome measured by 12-month outcome.Pediatric nephrology (Berlin, Germany) · 2019Observational
- Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium.Kidney international reports · 2019Review
- Article
- Mycophenolate mofetil for sustained remission in nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2018Article
- IPBMC nephrology · 2018Article
- The status quo and challenges of genetic diagnosis in children with steroid-resistant nephrotic syndrome.World journal of pediatrics : WJP · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The idiopathic nephrotic syndrome in childhood can be classified according to the International Study of Kidney Disease in Children (ISKDC) based on the response to steroids. Typically, steroid-sensitive nephrotic syndrome (SSNS) is characterised by minimal changes in disease (MCD) histology, whereas in steroid-resistant nephrotic syndrome (SRNS) focal segmental glomerulosclerosis (FSGS) is the most prevalent lesion. Patients with SSNS may develop frequent relapses and/or steroid dependency, which can be difficult to treat. New studies confirm the value of calcineurin inhibitors (CNIs) and mycophenolic acid in preventing relapses of SSNS. Rituximab also plays an important role, but many questions regarding initial dosing, repetitions of courses, and long-term side effects remain unclear. SRNS, especially when unresponsive to treatment, can lead to chronic kidney disease. In particular, treatment with CNIs has improved the prognosis and recent data indicate that treatment can even be discontinued in many patients with full remission. In CNI-unresponsive SRNS, rituximab is less effective than in SSNS and the role of other biologicals (such as ofatumumab, abatacept, and others) remains unclear. A significant proportion of children with FSGS have genetic causes and most patients do not respond to immunosuppression, although individual patients with partial and even complete response have been documented. Future studies should evaluate treatments leading to long-term remission without maintenance immunosuppression in SSNS; in both genetic and immune-mediated SRNS, novel options to decrease the number of treatment-unresponsive patients seem mandatory, as they are at a high risk of developing end-stage renal disease.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.