title: Early age at debut is a predictor of steroid-dependent and frequent relapsing nephrotic syndrome.
abstract: 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.
authors.affiliation: Department of Paediatrics, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark. rfa@ki.au.dk
authors.forename: René Frydensbjerg
authors.initials: RF
authors.lastname: Andersen
authors.forename: Nana
authors.initials: N
authors.lastname: Thrane
authors.forename: Karen
authors.initials: K
authors.lastname: Noergaard
authors.forename: Lene
authors.initials: L
authors.lastname: Rytter
authors.forename: Bente
authors.initials: B
authors.lastname: Jespersen
authors.forename: Søren
authors.initials: S
authors.lastname: Rittig
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D011241:Prednisone
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