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Indications for renal biopsy in nephrotic syndrome

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The most common variant of nephrotic syndrome in children in Minimal change nephrotic syndrome. In case of MCNS, there is no need to do a renal biopsy before starting treatment. But in certain atypical features at onset, it is necessary to do a renal biopsy. They are:
Age of onset less than 12 months
Gross hematuria
Persistent microscopic hematuria
Elevated blood pressure
Low blood C3
Impaired renal function
Proteinuria despite appropriate steroid therapy

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