All children with first episode of nephrotic syndrome should undergo detailed clinical assessment for presence of complications like massive edema, hypovolemia, presence of any serious infections and features suggestive of systemic illness.
Basic laboratory evaluation including a complete blood count, kidney function tests, serum albumin, cholesterol and urine routine microscopy should be done to confirm the diagnosis. Other tests like imaging (Chest X r-ray, ultrasound KUB), Autoimmune profile( C3, C4, ANA, ANCA) are done only if clinically indicated.
It is preferable to treat any complications before starting steroid treatment.
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