Indications for renal biopsy in nephrotic syndrome

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