Relationship of Childhood Idiopathic Nephrotic Syndrome with Asthma, Hypertension, Complement C₃, Urinalysis

Abstract

A prospective observational study of 43 children with idiopathic nephrotic syndrome (INS) were selected randomly out of 480 children admitted with the disease at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2003 to January 2005. Aim of this study was to correlate the difference in frequency of atopic attack, hypertension, complement c3 level and urinalysis in different types of Idiopathic nephrotic syndrome. Result: Among 43 children with idiopathic nephrotic syndrome (INS), 24 children were steroid sensitive nephrotic syndrome (SSNS) and 19 children having steroid resistant nephrotic syndrome (SRNS) cases, of SSNS group 13 were infrequent relapse nephrotic syndrome (IFRNS) and 11 were frequent relapse steroid dependant nephrotic syndrome (FRNS + SDNS). Bronchial asthma and allergic dermatitis were found in about 63% cases of both steroid resistant nephrotic syndrome (SRNS) and frequent relapse steroid dependant (FRNS+SDNS) group. Hypertension was found in higher number of patient in SRNS compared to SSNS (P> 0.05) It was absent in IFRNS. Steroid contributed more than the disease process in producing hypertension (P< 0.01). Complement C3 comparison among the group could not reach statistically significant level. Similarly, comparison of hematuria showed no difference among the groups but pyuria was higher in SRNS compared to IFRNS (P >0.05). UTI were found equally in all the groups. Conclusion: Higher incidence of asthma, atopic dermatitis were noted in all the groups of idiopathic nephrotic syndrome (INS). C3 was not found significantly low in INS. Persistent elevation of blood pressure is found in higher number of SRNS compared to SSNS and steroid contributed more than the disease process. DOI: http://dx.doi.org/10.3329/bjch.v35i1.10367 BJCH 2011; 35(1): 11-15

Blood Pressure Differences in Nephrotic Syndrome Patients with Steroid Resistant Nephrotic Syndrome Patients and Steroid Sensitive Nephrotic Syndrome

“…In new, in our study, there was a higher increase in systolic blood pressure in the SSNS group compared to the significant SRNS group, but there was no difference in diastolic blood pressure in the SRNS and SSNS groups. This compares with a 2011 study in Bangladesh in which there were more hypertension events found in the SRNS group than SSNS (p > 0.05) [2] and in line with research in Indonesia 2016 where blood pressure found in the SSNS group was higher than the SRNS group but not statistically meaningful [3]. Another study by Mamesah 2019 found the average systolic and diastolic blood pressure of the SRNS group compared to the SSNS group [9].…”

“…Hypertension that occurs in nephrotic syndrome (NS) is an event that will cause a poor prognosis in cases of NS both in the Steroid Resistant NS (SRNS) group and in the steroid sensitive NS (SSNS) group [1]. According to a 2011 study in Bangladesh found, more hypertension incidence was found in SRNS compared to the SSNS group [2]. However, in another study in Manado, the average systolic and diastolic blood pressure was higher in the SSNS group than in the SRNS group [3].…”

“…According to the response to steroids, SN can be classified into two, namely, SSNS and SRNS [1]. Syndrome nephrotic sensitive steroid cover 80-90% syndrome while the rest is SRNS [2].…”

“…Hypertension that occurs in children aged <1 year and > 8 year in children with renal impairment causes a poor prognosis [8]. Hypertension is more common in SRNS than SSNS (p > 0.05), steroid therapy is associated with the incidence of hypertension in an SN treatment regimen (p < 0.01) [2]. Patient SSNS has a higher average systolic and diastolic blood pressure than SRNS, but this hypertension event is not statistically meaningfully related to SRNS and SSNS [3].…”

Hubungan Aspek Klinis Dan Laboratorium Dengan Tipe Sindrom Nefrotik Pada Anak

“…Meskipun kekambuhan adalah sifat umum SN, 90-95% anak dengan SNKM responsif terhadap terapi steroid dengan menyelesaikan klinis remisi biokimia dan memiliki prognosis jangka panjang yang sangat baik. 7 Sindrom nefrotik pada anak yang didiagnosis secara histopatologik sebagai lesi minimal, sebagian besar akan memberikan respons terhadap pengobatan steroid. Pada SN lesi nonminimal sebagian besar tidak memberikan respons terhadap pengobatan steroid.…”