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J Pediatr. 2010 Jun;156(6):965-971. doi: 10.1016/j.jpeds.2009.12.020. Epub 2010 Mar 10.

Time for initial response to steroids is a major prognostic factor in idiopathic nephrotic syndrome.

Author information

1
Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy.
2
Department of Pediatrics, University Hospital of Alexandroupolis, Democritus University of Thrace-Medical School, Alexandroupolis, Greece.

Abstract

OBJECTIVE:

To identify early prognostic factors for idiopathic nephrotic syndrome (INS) in childhood.

STUDY DESIGN:

A retrospective analysis of 103 patients with INS at onset, all treated in a single center with the same induction protocol, was conducted. Minimum length of follow-up was 2 years; median length of follow-up was 43 months. Survival data were assessed with Cox-Mantel analysis. Predictive values were estimated with receiver operating characteristic curves.

RESULTS:

The median time of response to steroid therapy was 7 days. A significant association was found between the interval from onset of steroid therapy to remission and the risk of relapsing within 3 months after steroid therapy discontinuation (P < .0001). A similar association was found between the time to achieve remission and the risk of developing frequent relapsing or steroid-dependent nephrotic syndrome (P < .0001), the prescription of maintenance steroid therapy (P < .003), and the prescription of all other non-steroid drugs (P < .0001) during follow-up. Patients with non-relapsing and infrequent relapsing nephrotic syndrome had a median time to achieve remission <7 days; in patients with frequent relapsing and steroid-dependent nephrotic syndrome, this median was >7 days.

CONCLUSION:

The interval from onset of steroid therapy to remission is an accurate early prognostic factor in INS.

PMID:
20223477
DOI:
10.1016/j.jpeds.2009.12.020
[Indexed for MEDLINE]

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