What Do The Following Blood And Urine Test Reports Indicate?

Posted on Mon, 3 Aug 2015

Question: My niece is suspected with Nephrotic syndrome and necessary tests are conducted. The reports are attached herewith. Doctors at XXXXXXX hospital are reluctant to start the treatment and hence we are planning to shifted her to XXXXXXX

Kindly go through the reports and suggest the line of treatment and if possible the best child urologists in XXXXXXX

Answered by Dr. Dr. Pradeep Kumar Jain (6 hours later)

Brief Answer:
Infection should be treated first before starting steroid in nephrotic synd

Detailed Answer:
Hello

Thanks for the query

I have gone through the reports.The urine and blood tests done on 8/7/15 shows that apart from features of nephrotic syndrome(3+ urinary protein,raised cholesterol,low albumin) there is infection(in view of raised CRP 21) also.The age of your niece(>1 year) and normal C3,C4 level suggests that it is minimal change disease(most common form of nephrotic syndrome which shows good response to steroid).

The mainstay of management is steroid which should be given at least for two months.Before starting steroid any bacterial infection should be treated properly and few tests should be done(like mantoux and chest xray)to rule out tuberculosis infection.

Ceftriaxone is a good broad spectrum antibiotic.Usually infection resolves after 6-7 days of antibiotic.So I would like to continue the same treatment and get a repeat CBC and CRP done after 7 days of ceftriaxone therapy.If the CRP value becomes normal I would like to start prednisolone tablet at 2 mg/kg/day for 6 weeks.I don't think you need to shift to XXXXXXX for treatment of uncomplicated nephrotic syndrome.

I hope this helps.
Please do ask any further query if you have.
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar