Canadian Society of Nephrology Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis: management of nephrotic syndrome in children

Susan Samuel; Martin Bitzan; Michael Zappitelli; Allison Dart; Cherry Mammen; Maury Pinsk; Andrey V Cybulsky; Michael Walsh; Greg Knoll; Michelle Hladunewich; Joanne Bargman; Heather Reich; Atul Humar; Norman Muirhead

doi:10.1053/j.ajkd.2013.12.002

Canadian Society of Nephrology Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis: management of nephrotic syndrome in children

Am J Kidney Dis. 2014 Mar;63(3):354-62. doi: 10.1053/j.ajkd.2013.12.002. Epub 2014 Jan 11.

Authors

Affiliations

¹ Division of Pediatric Nephrology, Department of Pediatrics, University of Calgary, Calgary, Alberta. Electronic address: [email protected].
² Division of Pediatric Nephrology, Department of Pediatrics, McGill University, Montreal, Quebec.
³ Department of Pediatrics and Child Health, Section of Pediatric Nephrology, University of Manitoba, Winnipeg, Manitoba.
⁴ Department of Pediatrics, Division of Pediatric Nephrology, University of British Columbia, Vancouver, British Columbia.
⁵ Department of Pediatrics, Division of Pediatric Nephrology, University of Alberta, Edmonton, Alberta.
⁶ Department of Medicine, McGill University, Montreal, Quebec.
⁷ Division of Nephrology, Department of Medicine, McMaster University, Hamilton.
⁸ Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa.
⁹ Department of Medicine, University of Toronto, Toronto, Ontario.
¹⁰ Transplant Infectious Diseases, University of Alberta, Edmonton, Alberta.
¹¹ Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.

PMID: 24423782
DOI: 10.1053/j.ajkd.2013.12.002

Abstract

The KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for management of glomerulonephritis was recently released. The Canadian Society of Nephrology convened a working group to review the recommendations and comment on their relevancy and applicability to the Canadian context. A subgroup of pediatric nephrologists reviewed the guideline statements for management of childhood nephrotic syndrome and agreed with most of the guideline statements developed by KDIGO. This commentary highlights areas in which there is lack of evidence and areas in need of translation of evidence into clinical practice. Areas of controversy or uncertainty, including the length of corticosteroid therapy for the initial presentation and relapses, definitions of steroid resistance, and choice of second-line agents, are discussed in more detail. Existing practice variation is also addressed.

Keywords: Canadian Society of Nephrology (CSN); Clinical practice guideline implementation; KDIGO (Kidney Disease: Improving Global Outcomes); corticosteroids; glomerulonephritis; nephrotic syndrome; pediatric.

Publication types

Review

MeSH terms

Canada
Child
Disease Management*
Glomerulonephritis / complications
Glomerulonephritis / drug therapy*
Glucocorticoids / therapeutic use*
Humans
Nephrology*
Nephrotic Syndrome / drug therapy*
Nephrotic Syndrome / etiology
Practice Guidelines as Topic*
Prognosis
Societies, Medical*

Substances

Glucocorticoids