Risk factors for relapse in childhood steroid sensitive nephrotic syndrome
Journal Title: Indian Journal of Child Health - Year 2017, Vol 4, Issue 3
Abstract
Background: Nephrotic syndrome (NS) generally tends to follow a benign and chronic relapsing course. Relapses are a major problem in children with steroid sensitive NS (SSNS). Objective: To identify the risk factors for frequent relapse (FR) in the first episode childhood SSNS. Methods: This prospective study was conducted in the Government Dharmapuri Medical College Hospital, Tamil Nadu, between July 2013 and January 2016. Children aged 9 months - 12 years with a diagnosis of SSNS (first episode) who came for follow-up for at least 12 months in the pediatric nephrology clinic were included. The enrolled cases were divided into 2 groups: (1) frequent relapser (FR) and (2) infrequent relapser (IFR). 9 factors were studied as possible risk factors for relapse. The data collected were analyzed using Chi-square test and Student’s t-test. Results: Of 160 SSNS children, there were 92 (57.5%) cases of IFR and 68 (42.5%) cases of FR. There were 97 males (60.6%) and 63 females (39.4%) with a male to female ratio of 1.5:1. The mean age of presentation was 4.37±2.32 years. The mean time taken to achieve remission during the first episode was 1.94±1.04 weeks. The interval between remission and first relapse was 5.56±4.51 months. Incidence of infection and hypertension was 31.9% and 37.5%, respectively. Risk factors significantly associated with FR were: Time taken to achieve remission during the first episode (>14 days) (p<0.0001), mean duration of interval between remission and first relapse (within 6 months) (p<0.0001), associated infections (p<0.0001) and hypertension (p<0.0001). Age at onset, sex, serum albumin, 24 h urine protein, and azotemia did not influence the FR in our study. Conclusion: More than 14 days to achieve remission during the first episode, relapse within first 6 months, associated infections and hypertension were the factors associated with FRs.
Authors and Affiliations
J Balaji, K S Kumaravel, P Punitha, K Sasikala, B Rameshbabu
Keywords
Related Articles
- EP ID EP456410
- DOI -
- Views 99
- Downloads 0
Randomized controlled trial of antenatal magnesium sulfate for short-term neuroprotection in premature neonates
Objective: To test the hypothesis that antenatal magnesium sulfate (MgSO4) has a short term neuroprotective role in the early neonatal period, when given to women considered at risk for preterm delivery in a developing c...
Anti-neutrophil cytoplasmic antibodies negative eosinophilic granulomatous polyangiitis glomerulonephritis in children - A diagnostic dilemma
Anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) refers to small-to-medium vessel vasculitis with multisystemic involvement and is characterized by the presence of ANCA to specifically either pro...
Congenital malaria: Is it really rare? A case report
A 7-day-old term male infant weighing 2.4 kg was admitted with fever, pallor, icterus, and splenomegaly for 3 days. The primi mother was treated for pyrexia in the last trimester. Investigation revealed anemia, hyperbili...
Unintentional home injuries among children aged 1–9 years in slums of Burdwan Municipality, West Bengal: A cross-sectional study
Context: Unintentional home injuries result in morbidities among children. Aims: This study aimed to find out the prevalence and patterns of unintentional home injuries among children aged 1–9 years, in slums of Burdwan...
Exploring determinants of birth weight of the baby delivered in a tertiary hospital of Delhi
Introduction: Low birth weight (LBW) is a global public health challenge. In India, the prevalence is 22%. Objective: The aim of this study is to assess the major determinants of birth weight of the newborns delivered in...