Glomerular diseases in children commonly manifest as nephrotic syndrome. The nephrotic syndrome is characterized by edema, high cholesterol, low albumin, and severe protein in the urine. The most common cause is minimal-change disease, which typically responds well to corticosteroid therapy. Complications can include infections, electrolyte imbalances, and blood clotting issues. Treatment involves dietary changes, diuretics, antibiotics for infections, and corticosteroids as the primary therapy, with cytotoxic drugs used for resistant cases. Prognosis depends on the underlying histology, with minimal-change disease having a good long-term outlook in most cases.

1. Glomerular Diseases in Children Lecturer Xin Yue TIANJIN MEDICAL UNIVERSITY PEDIATRIC DPT. GENERAL HOSPITAL

2. Nephrotic syndrome (NS)

3. Introduction The nephrotic syndrome (NS) is characterized by Edema Hypercholesterolemia (greater than 5.72 mmol/L) Hypoalbuminemia (less than 30 g/L ) Severe proteinuria (greater than 0.05/kg/24hr)

4. Secondary nephrosis Primary nephrotic syndrome(90%) Types of nephrotic syndrome Congenital nephrosis Simple nephrosis Nephritic nephrosis

10. Normal Foot Processes Effacement of Foot Processes

14. MGN: Mildly Thickened Capillary Loops

22. The glomerular capillary wall: Charge selective filter The glomerular capillary wall: Size selective filter

37. Differential between simple and nephritic nephrosis Typical features Simple nephrosis Nephritic nephrosis Age 2~7 yr, peak age is 3 yr School age Edema Severe (ascites) Mild or moderate Hyperlipidemia ↑↑ ↑ Proteinuria + + + ~ + + + + ++ ~ +++ >50~100mg/kg/24hr <50mg/kg/24hr Serum albumin ↓↓ Normal/slightly ↓ Hematuria RBC < 10/HP RBC > 10/HP Blood pressure Normal Raised Complement C 3 Normal Normal/low Renal function Normal Abnormal Histological type MCNS FSGS, MPGN Prognosis well Bad