Disease Course in Steroid Sensitive Nephrotic Syndrome.
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Date
2012-11
Journal Title
Journal ISSN
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Abstract
Objective: To review the disease course in patients with steroid
sensitive nephrotic syndrome (SSNS) and the factors that
determine outcome
Design: Retrospective, analytical
Setting: Pediatric Nephrology Clinic at referral center in North
India
Participants/patients: All patients with SSNS evaluated between
1990 and 2005
Intervention: None
Main outcome measures: Disease course, in patients with at
least 1-yr follow up, was categorized as none or infrequent
relapses (IFR), frequent relapses or steroid dependence (FR),
and late resistance. Details on complications and therapy with
alternative agents were recorded.
Results: Records of 2603 patients (74.8% boys) were reviewed.
The mean age at onset of illness and at evaluation was 49.7±34.6
R E S E A R C H P A P E R
INDIAN PEDIATRICS 881 VOLUME 49__NOVEMBER 16, 2012
and 67.5±37.9 months respectively. The disease course at 1-yr
(n=1071) was categorized as IFR in 37.4%, FR in 56.8% and late
resistance in 5.9%. During follow up, 224 patients had 249
episodes of serious infections. Alternative medications for
frequent relapses (n=501; 46.8%) were chiefly cyclophosphamide
and levamisole. Compared to IFR, patients with FR were younger
(54.9±36.0 vs. 43.3±31.4 months), fewer had received adequate
(≥8 weeks) initial treatment (86.8% vs. 81.7%) and had shorter
initial remission (7.5±8.6 vs. 3.1±4.8 months) (all P<0.001). At
follow up of 56.0±42.6 months, 77.3% patients were in remission
or had IFR, and 17.3% had FR.
Conclusions: A high proportion of patients with SSNS show
frequent relapses, risk factors for which were an early age at
onset, inadequate initial therapy and an early relapse.
Description
Keywords
Frequent relapses, Minimal change disease, Steroid dependent nephrotic syndrome
Citation
Sinha Aditi, Hari Pankaj, Sharma Piyush Kumar, Gulati Ashima, Kalaivani Mani, Mantan Mukta, Dinda Amit Kumar, Srivastava Rajendra N, Bagga Arvind. Disease Course in Steroid Sensitive Nephrotic Syndrome. Indian Pediatrics. 2012 November; 49(11): 881-887.