| Title： | EPG Evidence-Based Clinical Practice Guideline for the Pediatric Nephrotic Syndrome (Steroid-Sensitive/ Steroid-Resistant) |
| Edition： | Adapted |
| Classification： | Standard guideline |
| Field： | Comprehensive guideline |
| Countries and regions： | Egypt |
| Guidelines users： | Pediatricians, Pediatric Nephrologists, Adult Nephrologists, Pathologists, Geneticists, Clinical Pharmacists, Dietitians at University Hospitals, and Ministry of Health (MOH) Governmental and private hospitals at secondary and tertiary care levels. Primary health care physicians at Ministry of Health (MOH)/ General practitioners/Family medicine specialists. |
| Evidence classification method： | The 'Formal' Guideline Adaptation Process (Wang et al 2018) followed by the EPG is the 'Adapted ADAPTE' (Amer et al 2015) that includes three phases (set up, adaptation, and finalization). Critical appraisal or quality assessment or evaluation of the eligible source original guidelines is conducted by using the AGREE II Instrument. The rating system for the hierarchy of evidence will follow the same system of the original guideline(s) with their permission. |
| Development unit： | Egyptian Pediatric Clinical Practice Guidelines Committee (EPG) |
| Registration time: | 2021-11-21 |
| Registration number： | IPGRP-2021CN374 |
| Purpose of the guideline: | 1. Steroid Sensitive Nephrotic Syndrome (SSNS) Proper initial diagnosis of nephrotic syndrome by practitioners and pediatricians recommending referral to pediatric nephrologists for extended assessment at a specialized and advanced level when indicated, with more available diagnostic procedures. proper treatment of cases at relapses and remissions, prevention and management of complications, Patient follow-up for family orientation with home monitoring of proteinuria, frequent outpatient clinic visits for assessment of the diseases, prevention and management of complications, drug monitoring, vaccinations, diet, and activity recommendations. 2. Steriod Resistant Nephrotic Syndrome (SRNS) proper Diagnosis workup referring to its type (i-. primary idiopathic, ii-secondary to drugs, infections, autoimmune disease, iii-Genetic). Identification of genetic types will avoid the use of immunosuppressive drugs. Identification of secondary types recommends the management of the cause. For Idiopathic types, immunosuppressive therapy plans depend on renal biopsy findings, patient response, and tolerance to the used drug. Proper treatment of NS is based on its type, (idiopathic, genetic, and secondary), pathology report, the severity of the disease presentation, and patient GFR. ESRF/SRNS should be recommended for transplantation in tertiary care Pediatric Nephrology Centers. Management of SRNS should be totally addressed to pediatric Nephrologists at secondary and tertiary levels. |
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