Time trends and ethnic patterns of childhood nephrotic syndrome in Yorkshire, UK

Abstract

Against the background of the increasing incidence of many immune mediated childhood conditions, this study aimed to identify recent time trends and ethnic patterns of childhood nephrotic syndrome. A population-based cohort of children (0-15 years) diagnosed according to strict criteria with nephrotic syndrome (NS) was ascertained within the northern UK region of Yorkshire between 1987 and 1998. South Asian ethnicity was assigned based on the child's full name using a dedicated computer algorithm and expert individual checks. NS was diagnosed in 194 children, 170 (88%) of whom were steroid sensitive. The incidence of steroid sensitive NS was 2.0/100,000 pyrs (95% CI 1.7-2.3), peaking in 1-4 year olds (4.1/100,000 pyrs). Over the 12-year study period incidence rates of steroid sensitive NS were fairly stable although south Asian children displayed significantly higher rates than non-south Asians (P<0.01). The size of our population-based series reflects the relative rarity of paediatric nephrotic syndrome but is nonetheless recent and includes larger numbers than previous reports. The absence of any increase in incidence over the last decade contrasts with other paediatric immune mediated conditions such as asthma and diabetes.

Risk of idiopathic nephrotic syndrome among children with asthma: a nationwide, population-based cohort study

“…The results suggest that children with asthma were more likely to develop INS regardless of sex, age, urbanization of living area, or parental occupation. The annual incidence of NS in children in the United States and in Europe has been estimated to be 1-7 per 100,000 children (1,23). The present study revealed an incidence rate of 2.76 of 100,000 personyears in the nonasthma cohort and a significantly increased incidence rate of 9.21 of 100,000 person-years in the asthma cohort.…”

Spectrum of Steroid-Resistant and Congenital Nephrotic Syndrome in Children

“…Approximately 12%-15% of children with idiopathic nephrotic syndrome do not respond to oral steroid therapy (1,2). Steroid-resistant nephrotic syndrome (SRNS) is a challenging clinical condition with highly variable outcomes, and 50% of children progress to ESRD within 15 years (3,4).…”

“…The ongoing discovery of genetic podocytopathies is about to redefine the physiopathologic understanding, diagnostic assessment, prognostic judgment, and therapeutic approaches in childhood-onset SRNS. However, the development of evidence-based management algorithms has been hampered by the low incidence of SRNS, which is estimated at 2-4 per million person-years (1).…”

Clinical Profile and Outcome of Steroid Resistant Nephrotic Syndrome in Children: An Eastern Indian Single Centre Study

“…Idiopathic Nephrotic syndrome (INS) affects about 2 per 1 lakh children aged ≤15 years [1,2]. About 10% to 20% of these children are resistant to steroids [1].…”

“…About 10% to 20% of these children are resistant to steroids [1]. Response to steroids is associated with a good longterm prognosis [3].…”