Introduction: Idiopathic Nephrotic Syndrome (INS) is regarded as proteinuria, hypoalbuminemia, generalized oedema and hyper lipidemia1. Minimal change disease (MCD) is the commonest (76.6%) histological variant of INS and 90% of them respond with adequate dose of steroid which have normal renal function over the long term2,3. Though 3-5% cases of MCD is responsive to steroid initially, but subsequently becomes resistant4. Approximately 10% INS are steroid resistant4. In the landmark study by International Study of Kidney Diseases in Children (ISKDC); MCD (Minimal Change Disease), FSGS (Focal segmental glomerulous Sclerosis) and MPGN (Membrano Proliferative Glomerulonephritis) each are accounted for about a quarter of children with steroid resistant nephrotic syndrome2. Though they are associated with atypical clinical and laboratory findings like hypertension, hematuria, renal insufficiency, low complement level etc with significant glomerular lesion; but during initial episodes, other histological variant of INS may not give any clinical and laboratory clue regarding histological variant. Usually these cases are referred to Pediatric Nephrologist after 4 weeks of steroid therapy, where as the case deserves