Abstract

A STUDY ON THE CHARACTERISTICS DETERMINING RESPONSE TO STEROIDS AND RELAPSES IN NEPHROTIC SYNDROME IN PAEDIATRIC PATIENTS

Author(s): Mohamed Thafseer, Aparna Namboodiripad, Vinod Jacob Cherian

BACKGROUND Nephrotic Syndrome is a common childhood disease with a high morbidity due to relapses. If there was a way to identify the children who are more likely to relapse, this would give accurate prognosis and facilitate early intervention. The present study observes the characteristics determining response to steroids in nephrotic syndrome and studies whether these characteristics are predictive of subsequent outcome. Thus, targeted interventions may be done based on these identified triggers. This will help to reduce relapses and decrease disease morbidity. MATERIALS AND METHODS This is a descriptive study done over a period of eighteen months in the paediatric age group (less than 12 years). After enrolment of 55 children with nephrotic syndrome, clinical examination and investigations were done. They were treated and followed up for 1 year. The characteristics of initial presentation were compared with the frequency of relapse. RESULTS A total of 96.4% of children with nephrotic syndrome responded to corticosteroid therapy. Among 71.9% who relapsed, half had frequently relapsing nephrotic syndrome (FRNS). Among children who took more than 7 days for remission, 64% had FRNS or Steroid dependant nephrotic syndrome (SDNS). In children who had remission within 7 days or less, only 14.3% had FR/SDNS and this was statistically significant. Among the children who had their first relapse in less than 6 months after remission, 84.6% had FR/SDNS. However, only 37.5% of the children who had their first relapse after 6 months following remission had FR/SDNS, and this was statistically significant. CONCLUSION The risk of a child developing frequent relapses and steroid dependence are increased with shorter time to first relapse and longer time for remission in the initial episode.