True about Nephrotic syndrome in a child – a) Minimal change disease is commonest causeb) Proteinuria of 4 gm/m2 hr is characteristicc) Cyclosporine & Azathioprine is mainstay of therapyd) Pretreatment biopsy is done in all casese) Spontaneous bacterial peritonitis is associated with it

Nephrotic syndrome in children Most children (90%) with nephrotic syndrome have a form of idiopathic nephrotic syndrome. Causes of idiopathic nephrotic syndrome are - i) Minimal change disease (85%)            ii) Mesangial proliferative GN             iii) FSGS Infections are a common complication of minimal change disease (Nephrotic syndrome) Commonly seen infections are - Spontaneous bacterial peritonitis (most common), UTI, Sepsis, pneumonia and cellulitis. There is increased susceptibility to infections in minimal change disease because of - Urinary losses of immunoglobulin’s & properdin factor B   Malnutrition      Defective cell-mediated immunity  Oedema/ascites Immunosuppressive therapy The bacteria most commonly implicated in these cases are Streptococcus pneumoniae (most common) and E. coll.