Title: Predictors of Relapse in Steroid Sensitive Nephrotic Syndrome
Authors: Fajrunnisa P., Shenoy Varadaraj K.
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.95
Abstract
Background: Nephrotic syndrome affects 1-3 per 100,000 children below 16 years. The majority of children have steroid sensitive nephrotic syndrome (SSNS) with a favorable prognosis, 10% do not respond and hence defined as steroid resistant. Even though SSNS has a favourable outcome, about half of them become frequent relapsers and or steroid dependent. Objectives of this study was to analyse the predictors of relapse in children with idiopathic steroid sensitive nephrotic syndrome.
Materials and Methods: A retrospective observational study was conducted in a medical college hospital in Mangalore in children aged 1-15 years who presented with first episode of nephrotic syndrome between Jan 2014 to September 2018. Data was extracted from the hospital records .Variables like children age of onset, gender, hypertension, hematuria, azotemia at onset and weeks to remission and presence of infection were collected.
Results: Out of 33 cases, 8 were non relapsers and 25 were relapsers, of whom 21 were males (63.6%) and 12 females (36.4%). Out of 21 males, 16 (76.2%) were relapsers and 5(23.8%) were non relapsers and among 12 females, 9 (75%) were relapsers and 3(25) were non relapsers. 60% had infrequent relapse and 40 % had frequent relapse. Of 25 patients who had relapse, 8 had hypertension at onset and 87.5% of them became frequent relapsers, this was statistically significant (p value – 0.002). Of 24 early responders, 66.7% developed relapse and 33.3% did not relapse. Out of 9 late responders, all had relapse and this result was statistically significant (p value-0.041).
Conclusion: Male gender, presence of hypertension at the onset and late response to steroids can predict future relapses in nephrotic syndrome.
Keywords: Nephrotic syndrome, predictors, relapse
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