Childhood Nephrotic Syndrome Management and Outcome: A Single Center Retrospective Analysis.
There is a paucity of information on outpatient management and risk factors for hospitalization and complications in childhood nephrotic syndrome (NS). We described the management, patient adherence, and inpatient and outpatient usage of 87 pediatric NS patients diagnosed between 2006 and 2012 in the Atlanta Metropolitan Statistical Area. Multivariable analyses were performed to examine the associations between patient characteristics and disease outcome. We found that 51% of the patients were treated with two or more immunosuppressants. Approximately half of the patients were noted to be nonadherent to medications and urine protein monitoring. The majority (71%) of patients were hospitalized at least once, with a median rate of 0.5 hospitalizations per patient year. Mean hospital length of stay was 4.0 (3.8) days. Fourteen percent of patients experienced at least one serious disease complication. Black race, frequently relapsing/steroid-dependent and steroid-resistant disease, and the first year following diagnosis were associated with higher hospitalization rates. The presence of comorbidities was associated with longer hospital length of stay and increased risk of serious disease complications. Our results highlight the high morbidity and burden of NS and point to particular patient subgroups that may be at increased risk for poor outcome.
Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1677 Tullie Circle, Atlanta, GA 30329, USA.
Chia-Shi
0000-0001-6941-0057
CS
Wang
Children's Healthcare of Atlanta, 1677 Tullie Circle, Atlanta, GA 30329, USA.
Jia
J
Yan
Children's Healthcare of Atlanta, 1677 Tullie Circle, Atlanta, GA 30329, USA.
Robert
R
Palmer
Children's Healthcare of Atlanta, 1677 Tullie Circle, Atlanta, GA 30329, USA.
James
J
Bost
Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA.
Mattie Feasel
MF
Wolf
Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1677 Tullie Circle, Atlanta, GA 30329, USA.
Larry A
LA
Greenbaum