Early age at debut is a predictor of steroid-dependent and frequent relapsing nephrotic syndrome.
The purpose of this study was to identify characteristics of patients with steroid-sensitive nephrotic syndrome (SSNS) that point to a high risk of frequent relapsing (FR) or steroid-dependent (SD) SSNS. A retrospective analysis of 54 consecutive patients with SSNS was performed. In this cohort, the incidence of idiopathic NS was 1.9/100,000, age at debut was 5.5 years, and the mean follow-up was 4.0 years. A total of 56% (30/54) of our patients were classified with FR/SD SSNS. FR/SD patients were significantly younger at debut than non-FR/SD patients (3.5 vs. 8.5 years, respectively; p < 0.002). Males were overrepresented in the FR/SD group (69 vs. 38%; p = 0.03). No differences were found in terms of haematuria, hypoalbuminaemia, or days to achieve remission. In total, 31 and 23 patients were on a 6 + 6-week (pred-long) and 4 + 4-week (pred-short) steroid treatment regimen, respectively. There was a reduction in the number of FR/SD patients in the pred-long group relative to the pred-short group (38 vs. 80%, respectively). In the pred-long group, the 12 FR/SD patients were younger than the 19 non-FR/SD patients (4.4 +/- 3.1 vs. 8.4 +/- 4.1 years; p<0.005). Low age at debut and male gender was associated with a high risk of SD/FR in this unselected series of SSNS patients despite the prolongation of the steroid course at debut of SSNS.
Andersen
René Frydensbjerg
RF
Department of Paediatrics, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark. rfa@ki.au.dk
Thrane
Nana
N
Noergaard
Karen
K
Rytter
Lene
L
Jespersen
Bente
B
Rittig
Søren
S
D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use*; D011379:Prognosis; D011507:Proteinuria / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies
D005938:Glucocorticoids; D011241:Prednisone
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