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Submitted: 17 Nov 2022
Accepted: 25 Feb 2023
ePublished: 18 Mar 2023
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J Nephropharmacol. 2023;12(2): e10571.
doi: 10.34172/npj.2023.10571

Scopus ID: 85163081378
  Abstract View: 897
  PDF Download: 633

Original

Predictive risk factors of steroid dependent nephrotic syndrome in children with idiopathic nephrotic syndrome

Ehsan Valavi 1 ORCID logo, Azar Nickavar 2* ORCID logo, Parisa Amoori 1 ORCID logo, Mohsen Fathi 1 ORCID logo, Bahareh Valavi 3 ORCID logo

1 Chronic Renal Failure Research Center, Department of Pediatric Nephrology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Department of Pediatric Nephrology, School of Medicine, Aliasghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran
3 Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
*Corresponding Author: Azar Nickavar, Email: anickavar@yahoo.com, , Email: Nikavar.a@iums.ac.ir

Abstract

Introduction: Steroid dependent nephrotic syndrome (SDNS) is a difficult and troublesome presentation of idiopathic nephrotic syndrome (INS) in children, with complicated management and increased morbidity.

Objectives: The aim of this study was to identify the predictive clinical and laboratory characteristics of patients with SDNS, for parents counseling, appropriate management and improving outcome.

Patients and Methods: A total of 374 children with steroid sensitive INS were evaluated in two groups as steroid dependent (group 1=199) and non-steroid dependent (group 2= 175) INS. SDNS was defined as ≥2 relapses during steroid reducing treatment or 15 days after discontinuation of corticosteroids.

Results: Mean age at presentation was significantly lower in children with SDNS than those without steroid dependency (P=0.022). Diagnostic age less than two years (P=0.016), total relapses (P<0.001), relapse/year (P<0.001), body mass index (BMI) (P=0.002) and serum cholesterol level (P=0.042) were significantly higher in children with SDNS, compared to those with low-frequent relapse. Mean relapse rate decreased significantly in SDNS with immunosuppressive treatment (P<0.001).

Conclusion: Age younger than two years at diagnosis, high BMI, high relapse rate/year and hypercholesterolemia at remission are suggested as predictors of SDNS in children with INS.


Implication for health policy/practice/research/medical education:

Management of idiopathic nephrotic syndrome (INS), especially with frequent relapses or steroid dependency has been a clinical challenge for both patients and parents. This study was conducted to investigate risk factors of steroid dependent nephritic syndrome for better management and reducing complications of early and long-term steroid treatment.

Please cite this paper as: Valavi E, Nickavar A, Amoori P, Fathi M, Valavi B. Predictive risk factors of steroid dependent nephrotic syndrome in children with idiopathic nephrotic syndrome. J Nephropharmacol. 2023;12(2):e10571. DOI: 10.34172/ npj.2023.10571.

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