Frequently relapsing nephrotic syndrome — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardNephrologyFrequently relapsing nephrotic syndromeRACP Paediatrics

A 4-year-old with steroid-sensitive nephrotic syndrome has had 4 relapses in the past 12 months and is becoming cushingoid. What is the most appropriate steroid-sparing agent to consider first?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Mycophenolate mofetil

For frequently relapsing or steroid-dependent nephrotic syndrome, steroid-sparing agents include mycophenolate mofetil, cyclophosphamide, cyclosporine, tacrolimus, or rituximab. Per KDIGO 2021, calcineurin inhibitors or mycophenolate mofetil are commonly used first-line steroid-sparing agents. Choice depends on side effect profile and specialist preference.

Reference: KDIGO – 2021 – Nephrotic Syndrome in Children; RCH Melbourne – 2023 – Nephrotic Syndrome CPG