Risk factors for relapse of steroid-sensitive nephrotic syndrome in children

Joheb Imtiaz Jamil; Wahida Khanam; M. Nazmul Hossain; Tanjina Sharifa; Mohammad Nasir Uddin; Mohammad Ahad Adnan; Sajia Akhter; Ifthakhar Ahmed

doi:10.18203/2349-3291.ijcp20261135

Authors

Joheb Imtiaz Jamil Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
Wahida Khanam Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
M. Nazmul Hossain Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
Tanjina Sharifa Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
Mohammad Nasir Uddin Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
Mohammad Ahad Adnan Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
Sajia Akhter Department of Pediatrics, 250 Bedded Hospital, Magura, Bangladesh
Ifthakhar Ahmed Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20261135

Keywords:

Nephrotic syndrome, Relapse, Remission, Renal function, Steroid

Abstract

Background: The management of nephrotic syndrome (NS) is often challenged in relapse cases. Authors aimed to find out the risk factors for relapse of steroid-sensitive nephrotic Syndrome.

Methods: This cross-sectional study was carried out in the department of pediatrics, ICMH, Dhaka, from July 2020 to June 2021. A total of 40 admitted as well as follow-up relapse cases of steroid-sensitive NS were enrolled and proceeded to clinical and laboratory evaluation.

Results: The mean onset of NS was 3.86±2.35 years. Frequently relapsing NS (FRNS) was found in 14 (35.0%) cases and infrequently relapsing NS (IFRNS) was 26 (65.0%) cases. The majority of children responded within 7 days to initial steroid therapy (75% in IFRNS group and 50% from FRNS group); again, 50% of children with FRNS needed a longer time (≥7 days) to respond to initial steroid therapy. RTI and UTI were higher in FRNS, whereas viral fever and diarrhea were higher in IFRNS. The age of onset of NS, mean serum albumin, serum cholesterol and serum creatinine were not statistically significant compared with the type of relapse. Time needed to respond with initial steroid therapy at 1st attack of NS had a statistically significant difference when compared with the type of relapse in children with SSNS.

Conclusions: RTI and UTI were seen to occur in higher frequency in relapse cases of NS. A longer time taken to achieve remission during the first episode was significantly associated with FRNS.

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