The long-term outlook to final outcome and steroid treatment results in children with idiopathic nephrotic syndrome

Abstract

Idiopathic Nephrotic Syndrome (INS) was defined as combination of a nephrotic syndrome and non-specific histological abnormalities of the kidney. Among these abnormalities, minimal change nephrotic syndrome (MCNS) is the most common. We report our experience with MCNS; its clinical course, treatments and outcomes. One-hundred twenty children (66 male, 54 female) with MCNS, admitted to Nephrology Department between 1987-2009 was assessed. Their clinical presentations, treatment and disease courses were reviewed. The mean duration of follow-up was 11.5 ± 1.9 years. Initially, all patients given prednisone 2 mg/kg/ day single dose per four weeks a followed by eight weeks of the same daily dose given every other day. After week 12, prednisone was progressively tapered off at the rate of 0.5 mg/kg per 15 daily intervals until complete discontinuation had been achieved by week 16. Steroid resistance was accepted as no achievement of remission following four weeks of prednisone 2 mg/kg/day followed by three intravenous pulses of corticosteroids. At the end of the initial steroid treatment, 106 (88.3%) patients were determinate steroid responsive while 14 (11.7%) patients were steroid resistance. Thirty-eight patients underwent biopsy. At the end of study recovery rate was increased from 88.3% to 94.1%. In conclusion, most of patients entered remission by our therapy end of follow up time. With the support of our satisfactory results among the whole study group, long-term prednisolone treatment still remains valid.

Changes in clinicopathological features of primary nephrotic syndrome in children over a 10 years period: Research Paper

“…In our study, there was no signi cant difference in the response to glucocorticoids between the two groups. Dincel et al [14] found that 88.3% of children with PNS were SSNS and 11.7% of patients were SRNS, which was in accordance with our ndings. Another study showed that approximately 10% of patients with PNS had SRNS, and SRNS pathology was predominantly FSGS [13].…”

“…Another study showed that approximately 10% of patients with PNS had SRNS, and SRNS pathology was predominantly FSGS [13]. Even though our study did not show any difference in the rate of SRNS, the proportion of SRNS was higher than that in Dincel et al's study [14], and slightly higher than that (10-20%) previously reported in China [11]. This suggested an increasing trend of SRNS in recent years.…”

“…There were 48 patients with an unknown steroid response because we were unable to follow them up. MCD, MsPGN, and FSGS are the most common pathological types of PNS in children [14][15] [1]. Our ndings further supported this conclusion.…”