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renal biopsy in nephrotic syndrome
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Renal biopsy may be diagnostic in a patient with the nephrotic syndrome:
In adults renal biopsy is performed unless:
- there is a history of diabetes mellitus with progressive renal impairment
- the patient is taking a drug known to cause nephrotic syndrome
In cases of drug-induced nephrotic syndrome the drug is withdrawn; a biopsy is performed only if the patient fails to improve.
Because more than 75% of cases of paediatric nephrotic syndrome are caused by minimal change disease, children are given a trial of steroids unless there are features suggestive of another cause such as:
- persistent microscopic haematuria
- persistent diastolic hypertension
- low serum C3 levels
- a poorly selective differential protein loss
Last reviewed 01/2018
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