A 4-year old boy presents with periorbital puffiness and mild abdominal distension for 1 week. O/E there was shifting dullness and the rest of the findings are within normal limits. Urine analysis shows 3+ proteinuria. What is the next best step in the management of this child:
|A.||Start prednisolone @2mg/kg/day|
Start prednisolone @1.5mg/kg/day
Get a 24-hour urinary protein, urine protein/creatinine ratio, serum albumin, and lipid profile done
Start furosemide @2mg/kg/day
Periorbital puffiness and mild ascites could probably indicate a diagnosis of nephrotic syndrome, but the diagnostic criteria have to be fulfilled before labeling the diagnosis and treatment commencement. The diagnostic criteria include proteinuria, hypoalbuminemia, edema, and hyperlipidemia. So investigations mentioned in the option C must be carried out first
Once the definitive diagnosis of the nephrotic syndrome has been made, prednisolone must be started @2mg/kg/day for 6 weeks followed by 1.5mg/kg/day on alternative days for 6 more weeks.