Table 1 ∣.
Clinical definitions
| Condition | Adults | Children |
|---|---|---|
| Proteinuria | Proteinuria of 300–3,400 mg per day or urinary protein to creatinine ratio <300 mg/g (or<300 mg/mmol) | Urinary protein to creatinine ratio >0.2 or proteinuria >100 mg/m2 per day or ≥4 mg/m2 per hour or positive urine dipstick149 |
| Nephrotic range proteinuria | Proteinuria of ≥3.5 g per day or urinary protein to creatinine ratio ≥3,000 mg/g (or ≥300 mg/mmol) with normal serum albumin | Urinary protein to creatinine ratio ≥200 mg/mmol (2 mg/mg) in first morning void or 24-hour urine sample ≥1,000 mg/m2 per day corresponding to 3+ or 4+ by urine dipstick or ≥40 mg/m2 per hour |
| Nephrotic syndrome | Proteinuria of ≥3.5 g per day or urinary protein to creatinine ratio of ≥3,000 mg/g (or ≥300 mg/mmol) with oedema, serum albumin of <3.0 g/dl and hypercholesterolaemia | Urinary protein to creatinine ratio ≥200 mg/mmol (2 mg/mg) in first morning void or 24-hour urine sample ≥1,000 mg/m2 per day corresponding to 3+ or 4+ by urine dipstick and either hypoalbuminaemia (serum albumin of <30 g/l) or oedema when serum albumin level is not available |
| Partial remission | Proteinuria of 0.3–3.5 g per day or urinary protein to creatinine ratio of 300–3,500 mg/g (or 30–350 mg/mmol) with >50% decrease from baseline and stable renal function | Urinary protein to creatinine ratio >20 mg/mmol but <200 mg/mmol and, if available, serum albumin ≥30 g/l |
| Complete remission | Proteinuria of <0.3 g per day or urinary protein to creatinine ratio of <300 mg/g (or <30 mg/mmol), stable renal function and normal serum albumin | Urinary protein to creatinine ratio ≤20 mg/mmol (0.2 mg/mg) or negative or trace dipstick on 3 or more consecutive occasions |
| Relapse | Proteinuria of >3.5 g per day or urinary protein to creatinine ratio of >3,500 mg/g (or >350 mg/mmol) after achievement of remission | Urinary protein to creatinine ratio of ≥200 mg/mmol (2 mg/mg) on a first morning urine sample or ≥3+ protein on urine dipstick for 3 consecutive days |
| Frequently relapsing nephrotic syndrome | Two or more relapses within 6 months (or >4 relapses within 12 months) | Two or more relapses within 6 months (or >4 relapses within 12 months) |
| Steroid-dependent nephrotic syndrome | Two or more relapses during or within 14 days of completing steroid therapy | Two consecutive relapses during corticosteroid therapy or within 14 days of ceasing therapy |
| Steroid-resistant nephrotic syndrome | Failure to achieve remission after 16 weeks of corticosteroid therapy | Failure to achieve remission after 4–6 weeks of corticosteroid therapya |