@article{discovery10040459,
         journal = {European Journal of Pediatrics},
            year = {2017},
           title = {Variability of diagnostic criteria and treatment of idiopathic nephrotic syndrome across European countries},
          number = {5},
           month = {March},
           pages = {647--654},
            note = {This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.},
          volume = {176},
        keywords = {Proteinuria, Prednisone, Steroid dependency, Steroid resistance, Rituximab, Guidelines},
            issn = {1432-1076},
        abstract = {The aim of the surveys conducted by the Idiopathic Nephrotic Syndrome Working Group of the ESPN was to study the possible variability of treatment in Europe at different stages of the disease by means of questionnaires sent to members of the Working Group. Four surveys have been completed: treatment of the first flare, treatment of the first relapse and the issue of steroid dependency, use of rituximab, and the management of steroid-resistant patients. A uniform treatment of the first flare was applied in only three countries, and ten additional centers have adopted one of the three main protocols. Reported treatment of the first relapse was relatively uniform, whereas the use of additional immunosuppressants in steroid dependency was widely variable. Rituximab had already been used in hundreds of patients, although the formal evidence of efficiency in steroid dependency was relatively recent at the time of the survey. The definition of steroid resistance was variable in the European centers, but strikingly, the first-line treatment was uniform throughout the centers and included the combination of prednisone plus calcineurin antagonists. Conclusion: The variability in the approach of idiopathic nephrotic syndrome is unexpectedly large and affects treatment of the first flare, strategies in the case of steroid dependency, as well as the definitions of steroid resistance.What is Known:? Steroids and immunosuppressants are the universal treatment of idiopathic nephrotic syndrome.What is New:? The variability of treatments and strategy of treatment in European centers of pediatric nephrology.},
          author = {Desch{\^e}nes, G and Vivarelli, M and Peruzzi, L and Alpay, H and Alvaro Madrid, A and Andersen, R and Bald, M and Benetti, E and Berard, E and Bockenhauer, D and Boyer, O and Brackman, D and Dossier, C and Ekinci, Z and Emma, F and Enneman, B and Espinosa-Roman, L and Fila, M and Ghio, L and Groothoff, JW and Guigonis, V and Jankauskiene, A and Kagan, M and Kovacevic, M and Kemper, MJ and Levtchenko, E and Maringhini, S and Mir, S and Mitsioni, A and Mizerska-Wasiak, M and Wasiak, K and Moczulska, A and Montini, G and Murer, L and Nuutinen, M and Obukhova, V and Oh, J and Ozkaya, O and Papalia, T and Peco Antic, A and Pecoraro, C and Pena-Carrion, A and Petrossian, E and Pietrement, C and Prikhodina, L and Querfeld, U and Rittig, S and Saleem, MA and Saraga, M and Savenkova, N and Sever, L and Tullus, K and Ulinski, T and Vande Walle, J and Vara, J and Webb, N and Weber, LT and Zurowska, A},
             url = {https://doi.org/10.1007/s00431-017-2891-2}
}