The characteristics of relapse in adult-onset minimal-change nephrotic syndrome.
BACKGROUND
Although minimal-change nephrotic syndrome (MCNS) is highly steroid-responsive, the frequency of relapses in some patients is high, necessitating the administration of repeated courses of prednisolone in high doses. It is, therefore, necessary to identify factors that can predict this increased risk of relapse in some patients in order to establish useful treatment methods to reduce the risk.


METHODS
To clarify the factors that might increase the risk of relapses, the data of 82 Japanese adult patients with MCNS receiving treatment at our department were analyzed retrospectively. Of the total, 55 patients (67.1%) experienced relapse after showing an initial response. We divided the patients into two groups; namely, the nonrelapse group (n = 27) and the relapse group (n = 55), and compared the clinico-pathophysiological characteristics between the two groups.


RESULTS
Significantly increased serum immunoglobulin E (IgE) levels (P = 0.0002) and increased frequency of steroid side effects were observed in the relapse group as compared to the nonrelapse group.


CONCLUSIONS
To develop effective therapeutic modalities, it is important to have a thorough understanding of the clinico-pathophysiological characteristics of MCNS patients showing relapse.
Takei
Takashi
T
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan. ttakei@kc.twmu.ac.jp.
Koike
Minako
M
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Suzuki
Koichi
K
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Shirota
Satsuki
S
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Itabashi
Mitsuyo
M
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Ohtsubo
Shigeru
S
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Sugiura
Hidekazu
H
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Suzuki
Keiko
K
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Kojima
Chiari
C
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Takahashi
Masaki
M
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Ino
Jun
J
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Ogawa
Tetsuya
T
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Uchida
Keiko
K
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Tsuchiya
Ken
K
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Yumura
Wako
W
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Nitta
Kosaku
K
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies
D005938:Glucocorticoids; D007073:Immunoglobulin E; D011239:Prednisolone