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Steroid-Resistant NS — RACP Paediatrics MCQ

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ModerateNephrologySteroid-Resistant NSRACP Paediatrics

A 10-year-old presents with nephrotic syndrome. Despite 4 weeks of prednisolone 60 mg/m2/day, he still has 3+ proteinuria. What is this classified as?

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Correct answer: E — Steroid-resistant nephrotic syndrome

Steroid-resistant nephrotic syndrome (SRNS) is defined as failure to achieve remission (persistent proteinuria) after 4-6 weeks of prednisolone at 60 mg/m2/day. Renal biopsy is indicated to determine histology (often FSGS). Genetic testing for podocyte gene mutations should be considered. Second-line agents include calcineurin inhibitors.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Nephrotic Syndrome