中国实用儿科杂志2025，Vol.40Issue(7)：529-534,6.DOI:10.19538/j.ek2025070601
《KDIGO 2025版儿童肾病综合征临床实践指南》解读
Interpretation of the KDIGO 2025 clinical practice guideline for the management of nephrotic syndrome in children
摘要
Abstract
Primary nephrotic syndrome is the most common glomerular disease in childhood.The 2025 KDIGO Guidelines integrate the latest evidence to update the diagnosis and treatment strategies for childhood steroid-sensitive nephrotic syndrome(SSNS)and steroid-resistant nephrotic syndrome(SRNS).In diagnosis,some definitions are revised,and a"confirmation period"is proposed to clarify the diagnosis of SRNS;prognosis is related to the response to glucocorticoids and the frequency of relapses.In treatment,an 8-12-week regimen of initial glucocorticoids is recommended,with individualized use of glucocorticoids during infections.For frequently relapsing/steroid-dependent nephrotic syndrome(FR/SDNS),combination therapy with steroid-sparing agents[such as calcineurin inhibitors(CNIs),rituximab,etc.]is suggested.For SRNS,genetic testing should be performed as soon as possible,with CNIs as the initial second-line treatment.The outlook indicates that future research should focus on the exploration of shortening the initial course of glucocorticoids,optimizing the selection and dosage of steroid-sparing agents,achieving stratified diagnosis and treatment by integrating genetics and biomarkers,while paying attention to the safety of B-cell depletion therapies and quality-of-life endpoints to promote precision medicine practice.关键词
儿童/指南/肾病综合征/激素助减剂Key words
child/guideline/nephrotic syndrome/steroid-sparing agents分类
医药卫生引用本文复制引用
王晶晶,毛建华..《KDIGO 2025版儿童肾病综合征临床实践指南》解读[J].中国实用儿科杂志,2025,40(7):529-534,6.基金项目
浙江省科学技术厅"尖兵领雁+X"研发攻关计划(2024C03211) （2024C03211）
