associated with oligoanuria and electrolyte disturbance, RRT may be required until renal recovery is achieved NEPHROTIC SYNDROME CLINICAL PEARLS AND PITFALLS Nephrotic syndrome is characterized by edema, hypertension, proteinuria, hypoalbuminemia, and hyperlipidemia The most common cause in childhood is minimal change disease (MCD) Patients may be intravascularly depleted despite signs of overall fluid overload Children with nephrotic syndrome are at increased risk for serious bacterial infections and thrombosis Current Evidence Nephrotic syndrome is the clinical expression of a variety of glomerular diseases and can be classified as primary (without evidence of systemic illness), secondary, or congenital Primary nephrotic syndrome includes idiopathic nephrotic syndrome and nephrotic syndrome associated with primary glomerulonephritis Secondary nephrotic syndrome is associated with systemic disorders such as chronic hepatitis B infection and SLE Nephrotic syndrome diagnosed within the first months of life is termed congenital nephrotic syndrome; when it is diagnosed between and 12 months of life, it is called infantile nephrotic syndrome Most of these children have a genetic basis for renal disease Congenital nephrotic syndrome may also be due to intrauterine infection, such as congenital syphilis, toxoplasmosis, CMV, human immunodeficiency virus, and other organisms In children younger than 16 years, the annual incidence of nephrotic syndrome is approximately per 100,000 Presentation within the first year of life is uncommon, and nephrotic syndrome within the first months of life should raise the suspicion for congenital nephrotic syndrome Idiopathic nephrotic syndrome is the most common form of childhood nephrosis with