Publication:

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

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.