08/11/2025
“Hello everyone! I’m Dr. Amit Agarwal, Pediatric Nephrologist.
Today, let’s talk about what’s new in the 2025 KDIGO guidelines for managing Nephrotic Syndrome in Children.
If your child has nephrotic syndrome, this video will help you understand how treatment recommendations have evolved and what that means for your family.”
🧠 1. Understanding the Update
KDIGO – or Kidney Disease: Improving Global Outcomes – released its new guideline for childhood nephrotic syndrome in 2025.
The focus this time is on personalized care, reducing steroid side-effects, and using genetic and biopsy tools wisely.
💉 2. Steroid Use – Shorter and Smarter
Earlier, we often used long courses of steroids for the first episode.
Now, the 2025 KDIGO update supports shorter initial steroid courses – around 8–12 weeks instead of the very long schedules used before.
Studies show this achieves the same remission rates with fewer side-effects like weight gain, mood changes, and growth issues.
So – shorter course, same benefit, fewer problems.
🧬 3. Biopsy and Genetic Testing – Clearer Pathways
The new guideline introduces a stepwise algorithm to decide when to do a kidney biopsy or order genetic testing.
This helps identify children whose disease may not respond to steroids or who have a genetic form of nephrotic syndrome.
In practical terms – it means earlier, smarter diagnosis and avoiding unnecessary treatments.
💊 4. Immunosuppressive Agents – No Fixed Order
Previously, we followed a “first-line” and “second-line” list of medicines like cyclophosphamide, MMF, tacrolimus, or rituximab.
The 2025 KDIGO guideline now says — there is no strict hierarchy.
The best medicine should be chosen based on:
your child’s pattern of relapses,
side-effect profile,
cost and availability, and
family preference.
This approach encourages shared decision-making between parents and doctors.
🌍 5. Aligning Definitions and Global Relevance
KDIGO 2025 harmonizes definitions — such as frequent relapses, steroid-dependence, and steroid-resistance — with other international societies.
This means better global consistency and easier comparison of studies.
For countries like India, it helps integrate evidence-based care while respecting local realities.
⚖️ 6. Focus on Reducing Treatment Burden
A big theme is minimising toxicity and focusing on the child’s growth, nutrition, and mental well-being.
Doctors are encouraged to avoid overtreatment and tailor the plan to each child’s risk of relapse.
💬 Closing Message:
“In summary, the KDIGO 2025 guideline brings a more balanced, child-friendly approach —
✔️ Shorter steroid courses,
✔️ Individualised therapy choices, and
✔️ Better use of genetic tools.
It’s all about precision care and less burden for families.
Remember — every child is unique, and these guidelines help doctors and parents work together for the best outcomes.”
https://youtu.be/20Pt95VXLos
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“Hello everyone! I’m Dr. Amit Agarwal, Pediatric Nephrologist.Today, let’s talk about what’s new in the 2025 KDIGO guidelines for managing Nephrotic Syndrome...
