title: Triggers of relapse in steroid-dependent and frequently relapsing nephrotic syndrome.
abstract: An awareness of the triggers of relapse is critical for the control of steroid-dependent, frequently relapsing nephrotic syndrome (SDFRNS). We have investigated the triggers, usually described as 'episodes', to such relapses within a temporal context. Thirty-five patients with SDFRNS were analyzed retrospectively. A total of 442 relapses occurred in 2499 patient-months. The relapses were classified into two groups: those with episodes (E+) and those without episodes (E-). There were 135 E+ relapses and 296 E- relapses. The common cold was the most common episode (52%) of E+ relapse, followed by school events (18%). These E+ relapses occurred almost evenly throughout the 4 weeks between each follow-up visit. Conversely, 161 (55%) of the 296 E-z relapses occurred within the 3-day period preceding the patient's appointment (relapse-related hospital visit, RRHV). McNemar's test revealed that the concentration of relapses in this period was statistically significant (P < 0.00011). In addition, 15 out of 26 RRHV without additional therapy showed a spontaneous remission. From a chronological perspective, the common cold and school events as well as up-coming hospital visits may trigger relapses in SDFRNS patients.
authors.affiliation: Department of Pediatrics, Nihon University School of Medicine, 1-8-13 Chiyoda Ward, Kandasurugadai, Tokyo, 101-8309, Japan. shori@med.nihon-u.ac.jp
authors.forename: Shori
authors.initials: S
authors.lastname: Takahashi
authors.forename: Naohiro
authors.initials: N
authors.lastname: Wada
authors.forename: Hitohiko
authors.initials: H
authors.lastname: Murakami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Funaki
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Inagaki
authors.forename: Kensuke
authors.initials: K
authors.lastname: Harada
authors.forename: Michio
authors.initials: M
authors.lastname: Nagata
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D000846:Anniversaries and Special Events; D002648:Child; D002675:Child, Preschool; D003139:Common Cold / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D012008:Recurrence; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use; D013312:Stress, Physiological / Q000150:complications*
chemical_list: D013256:Steroids