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Indian Pediatr. 2012 Nov;49(11):881-7. Epub 2012 Mar 30.

Disease course in steroid sensitive nephrotic syndrome.

Author information

1
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

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 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.

PMID:
22791676
[Indexed for MEDLINE]
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