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Can we predict relapses in children with idiopathic steroid-sensitive nephrotic syndrome?

Om P Mishra1, Abhishek Abhinay, Rabindra N Mishra

  • 1Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.

Journal of Tropical Pediatrics
|April 27, 2013
PubMed

Insights

Younger age at onset and delayed response to prednisolone therapy predict relapse in childhood idiopathic nephrotic syndrome. Early treatment response is key to reducing relapse risk in these children.

Area of Science:

  • Pediatrics
  • Nephrology
  • Clinical Medicine

Background:

  • Idiopathic nephrotic syndrome (INS) is a common kidney disease in children.
  • Relapse is a frequent complication of INS, impacting long-term outcomes.
  • Identifying predictors of relapse is crucial for effective management.

Purpose of the Study:

  • To determine the predictors of relapse in children with a first episode of idiopathic nephrotic syndrome.
  • To investigate the association between age at disease onset and relapse risk.
  • To evaluate the impact of treatment response time on relapse rates.

Main Methods:

  • A prospective study followed 150 children with a first episode of INS for 12 months.
  • Data collected included age at onset, time to treatment response, and occurrence of relapses.
  • Statistical analysis was used to identify significant predictors of relapse.

Main Results:

  • 59.3% of children experienced at least one relapse within 12 months.
  • Disease onset between 1-3 years significantly increased relapse risk (2.99 times higher than >6 years).
  • Delayed response to prednisolone (>4 weeks) was associated with a higher risk of relapse (p=0.023).
  • Infections were more common at the time of relapse (p<0.001).

Conclusions:

  • Younger age at disease onset (1-3 years) is a significant predictor of relapse in childhood INS.
  • Delayed response to prednisolone therapy is another key predictor of relapse.
  • Early recognition and intervention for these risk factors may help prevent relapses.

Keywords:
childrennephrotic syndromeoredictorsrelapse

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