Triggers of relapse in steroid-dependent and frequently relapsing nephrotic syndrome

Abstract

An awareness of the triggers of relapse is critical for the control of steroid-dependent, frequently relapsing nephrotic syndrome (SDFRNS). We have investigated the triggers, usually described as 'episodes', to such relapses within a temporal context. Thirty-five patients with SDFRNS were analyzed retrospectively. A total of 442 relapses occurred in 2499 patient-months. The relapses were classified into two groups: those with episodes (E+) and those without episodes (E-). There were 135 E+ relapses and 296 E- relapses. The common cold was the most common episode (52%) of E+ relapse, followed by school events (18%). These E+ relapses occurred almost evenly throughout the 4 weeks between each follow-up visit. Conversely, 161 (55%) of the 296 E-z relapses occurred within the 3-day period preceding the patient's appointment (relapse-related hospital visit, RRHV). McNemar's test revealed that the concentration of relapses in this period was statistically significant (P < 0.00011). In addition, 15 out of 26 RRHV without additional therapy showed a spontaneous remission. From a chronological perspective, the common cold and school events as well as up-coming hospital visits may trigger relapses in SDFRNS patients.

Protective effects of Huang Qi Huai granules on adriamycin nephrosis in rats

“…Related pharmacological studies have shown that trametes robiniophila murr, being rich in polysaccharides, is a biological response modifier and can stimulate many elements of the immune system to enhance immunity. Clinical studies have shown that it has certain effects on children with recurrent respiratory tract infections [3,4], which is one cause of relapse in children with primary nephrotic syndrome [5,6]. Therefore, in the present study, ADR rat models were selected to observe the effects of HQH on experimental renal disease and to explore its mechanism of action.…”

Analysis of Predictors of Relapse in Children with Steroid Sensitive Nephrotic Syndrome

“…However, about 70% of the children experience relapsing course in the next 12 months nontreatment period 3 . The relapses are often precipitated by infections 6,9,14 which become troublesome for the patients as well as parents. Certain factors such as age, gender, time to response, duration of treatment of initial episode and frequency of relapses in the initial six months have been found to predict the relapses in these patients 1,10,16 .…”

Nephrotic Syndrome Outcome in Children: An Epidemiological Study

“…A study on the epidemiology of renal failure (RF) expressed high incidence of RF at PUHC-CDG of Ouagadougou (13). Takahashi et al, conducted a study on relapse triggers in children with steroid dependency; they observed 442 relapses in 2499 patients (14). Yousefichaijan et al, observed no statistically significant correlation between children with attention deficit hyperactivity disorder (ADHD) and steroiddependent nephrotic syndrome (SDNS), and their healthy counterparts (15), which was not investigated in the current study.…”