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Renal biopsy in nephrotic syndrome

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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In cases of drug-induced nephrotic syndrome the drug is withdrawn; a biopsy is performed only if the patient fails to improve.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

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