Significance of repeat renal biopsies in children with refractory nephrotic syndrome

Objective To observe the pathological changes in children with frequently relapsing and refractory nephrotic syndrome.Methods 49 children with refractory nephrotic syndrome were repeated renal biopsy,and their pathology were compared.Results The 1st time of renal biopsy to repeated biopsy from 10 to 48 months,the mean interval was 20.6 months.At the time of the second biopsies,pathological changes in 12 cases and the pathologic change rate was 24.49%,pathological transformation of up to MCD(9 cases,75.0%),followed by MsPGN(3 cases,18.75%).FSGS,IgAN,MPGN and MN was not found in pathological transition.Conclusion These results suggest that the therapy management should be adjusted if the children with frequently relapsing and refractory nephrotic syndrome did not have a satisfactory clinical response.It is advocated that perform a repeat biopsy repeat biopsy as soon as possible if the effect is still poor,to keep abreast of pathological changes,adjustment and development of new treatment options.