ISSN - 0973-0958
   
 
Outcome of Childhood Onset First Episode of Nephrotic Syndrome
A Boussetta, M Jellouli, M Brika, M Ferjani, Y Hammi, C Zarrouk, O Naija, T Gargah.
Pediatric Nephrology Department, Charles Nicolle hospital, Tunis, Tunisia.
 
Abstract

Background: Most patients with idiopathic nephrotic syndrome (NS) are steroid-responsive, about 50% relapse and often become steroid-dependent. The aim of this study was to determine epidemiology, treatment and outcome of children with first episode of NS.
Methods: This was a retrospective hospital-based cohort study in the department of pediatric nephrology of Charles Nicolle, Tunis, between 2002 and 2012. It included 52 children with idiopathic NS aged from 1 to 12 years, hospitalized for the first manifestation of the NS and followed for at least one year.
Results: The median age of presentation was 5.1±2.5 years. Male to female ratio was 2.7:1. Family history of atopy was found in 14 (26.9%) patients and personal atopy was noted in 9 (17.3%) patients. Microscopic hematuria was seen in 33 (63.5%) patients. The mean blood level of albumin was 1.17±4.2 g/dl, alpha-2 globulin was 1.71±3.5g/dl, cholesterol was 413.7±2.4 mg/dl and the mean proteinuria was 148±70 mg/kg/day. The mean time for first remission was 15.8±2 days. Thirty-eight patients (73%) relapsed and 31 patients (59.6%) became steroid dependent. Total 32 (61.5%) patients recovered from their NS with average interval between the onset of illness and recovery being 3.8±2.1 years (range: 2-10 years). Twenty-two (42.3%) required immunosuppressive drugs such as cyclophosphamide, mycophenolate mofetil and cyclosporine. Thirty-two patients (61.5%) were in remission and off therapy for more than 2 years. The most frequents adverse effects of steroid treatment were growth failure in 22 (42.3%) and osteoporosis in 7 (21.8%) patients. Renal functions remained normal for all patients.
Conclusion: The prognosis of idiopathic NS is good but the risk of progression to steroid dependence is high, which exposes these children to complications of long-term corticosteroid therapy. Prospective trials are necessary to identify effective and safe therapies for patients with frequent relapses and steroid dependence.
ask a doctor
Ask a Doctor
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0