Early age at debut is a predictor of steroid-dependent and frequent relapsing nephrotic syndrome

Pediatr Nephrol. 2010 Jul;25(7):1299-304. doi: 10.1007/s00467-010-1537-7. Epub 2010 May 6.

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.

MeSH terms

  • Adolescent
  • Age Factors
  • Age of Onset
  • Child
  • Child, Preschool
  • Cohort Studies
  • Denmark / epidemiology
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Infant
  • Male
  • Nephrotic Syndrome / drug therapy*
  • Nephrotic Syndrome / epidemiology*
  • Nephrotic Syndrome / pathology
  • Prednisone / therapeutic use*
  • Prognosis
  • Proteinuria / drug therapy
  • Proteinuria / epidemiology
  • Proteinuria / pathology
  • Recurrence
  • Retrospective Studies

Substances

  • Glucocorticoids
  • Prednisone