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Resolution versus persistence of childhood idiopathic nephrotic syndrome-A population-based study

Evgenia Gurevich1,2,3, Odeyah Abeles4, Daniel Landau5,6

  • 1Southern District Clalit Health Services, Pediatric Nephrology, Beer Sheva, Israel.

Acta Paediatrica (Oslo, Norway : 1992)
|October 7, 2024
PubMed

Insights

Most children with idiopathic nephrotic syndrome (INS) achieve remission by age 11.2. However, about a fifth of relapsing patients experience continued disease into adulthood, necessitating careful transition to adult care.

Area of Science:

  • Pediatrics
  • Nephrology
  • Immunology

Background:

  • Idiopathic nephrotic syndrome (INS) is a significant kidney disorder in children.
  • Understanding the long-term course of relapsing INS is crucial for patient management and prognosis.

Purpose of the Study:

  • To determine the duration and long-term outcomes of relapsing childhood idiopathic nephrotic syndrome.
  • To identify factors associated with disease persistence into adulthood.

Main Methods:

  • Retrospective analysis of a large, population-based health maintenance organization database.
  • Inclusion of children aged 2-10 years with a new INS diagnosis and corticosteroid prescription between 2000-2010.
  • Classification of NS category based on corticosteroid and/or steroid-sparing agent purchases.

Main Results:

  • Out of 608 eligible children, 113 (21.6%) had persistent disease into adulthood, with a mean age of 19.3 years.
  • The majority of patients (411) entered long-lasting treatment-free remission by age 11.2 ± 5.7 years.
  • Patients with more frequent medication purchases showed an older age at last relapse and higher steroid-sparing agent use.

Conclusions:

  • Childhood idiopathic nephrotic syndrome typically enters remission by age 11.2 years.
  • A significant proportion of patients with relapsing INS continue to have active disease into adulthood.
  • Transition of care from pediatric to adult services is essential for patients with persistent INS into adulthood.
Abstract

Keywords:
corticosteroidsdisease relapsedisease remissionnephrotic syndromesteroid‐sparing agents

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