title: Nephrotic syndrome in children: risk factors for steroid dependence.
abstract: Background - Most patients with idiopathic nephrotic syndrome are steroid-responsive, about 50% relapse and often become steroid-dependent and exposed to long-term steroid complications. The aim of this study was to determine predictive risk factors for steroid dependence using clinical and biological variables present at onset of the disease. It may be useful to adapt the therapeutic strategy. Methods - Retrospective hospital-based cohort study in the department of pediatric nephrology of Charles Nicolle, Tunis, between 2002 and 2012 included 52 children with idiopathic steroid-responsive nephrotic. Results - Risk factors for steroid dependency identified from univariate analysis were season of the first episode (winter or autumn) (p=0.008), hyperalpha2globulinemia>16g/l (p=0.028), hyperbeta2globulinemia >3g/l (p=0.003), hypercholesterolemia>10mmol/l (p=0.001), proteinuria>110mg/kg/day (p=0.05), time to achieve remission>9 days (p=0,0001). Logistic regression revealed that time to first remission and hypercholesterolemia>10mmol/l at first presentation were independent risk factors for steroid dependency. Conclusion - Time to first remission, hypercholesterolemia more than 10mmol/l at first presentation and a respiratory tract infection at first relapse are independent risk factors for steroid dependency.
authors.forename: Manel
authors.initials: M
authors.lastname: Jellouli
authors.forename: Meriem
authors.initials: M
authors.lastname: Brika
authors.forename: Kamel
authors.initials: K
authors.lastname: Abidi
authors.forename: Meriem
authors.initials: M
authors.lastname: Ferjani
authors.forename: Ouns
authors.initials: O
authors.lastname: Naija
authors.forename: Yousra
authors.initials: Y
authors.lastname: Hammi
authors.forename: Tahar
authors.initials: T
authors.lastname: Gargah
mesh_terms: D000704:Analysis of Variance; D002648:Child; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011507:Proteinuria / Q000150:complications; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000209:etiology*; D013997:Time Factors; D055542:alpha-Globins
chemical_list: D013256:Steroids; D055542:alpha-Globins