EVALUATION OF CLINICAL COURSE, RIRSK FACTORS FOR RELAPSE AND LONG-TERM OUTCOME OF CHILDREN WITH PRIMARY NEPHROTIC SYNDROME

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ATAEI N.; MADANI ABAS; FALAK ALAFLAKI B.

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Journal: TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ) Year:2003 | Volume:61 | Issue:4 Page(s): 308-319

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Title

EVALUATION OF CLINICAL COURSE, RIRSK FACTORS FOR RELAPSE AND LONG-TERM OUTCOME OF CHILDREN WITH PRIMARY NEPHROTIC SYNDROME

Author(s)

ATAEI N. | MADANI ABAS | FALAK ALAFLAKI B. | Issue Writer Certificate

Keywords

PRIMARY NEPHROTIC SYNDROMEQ4

CLINICAL COURSEQ4

RELAPSEQ4

RISK FACTORSQ4

LONG-TERM OUTCOMEQ4

Abstract

Background: The nephrotic syndrome is the most common chronic renal disease of childhood.Materials and Methods: In this study the CLINICAL COURSE, RISK FACTORS for RELAPSE and the predictors of LONG-TERM OUTCOME of 502 patients (median age 5 years)with PRIMARY NEPHROTIC SYNDROME were followed for an average of 60 months (3.5 to 240 months) from 1981 to 2000.Results: Among the 502 patients 5 (1%) achieved spontaneous remission and 313 children were initial responder. One hundred eighty four patients received at least 1 kidney biopsy (78 prior and 106 after initiation of treatment). Of 104 children with frequently relapsing steroid sensitive and steroid dependent nephrotic syndrome, levamisole induced prolong remission in 33 (31.7%) of patients. Cyclophosphamid and cyclosporine A induced prolong remission in 49 (50%) of 98 and 28 (41.3%) of 68 patients respectively. At the time of the final clinical evaluation, 73 patients (14.5%) were on remission; 301 (59.9%) had relapsing; 43 (8.6%) had persistent nephrotic syndrome; 33 (6.6%) of patients evolving to end-stage renal disease (ESRD) and 6 (1.2%) of them with chronic renal failure died (infection and cardio respiratory were the cause of death in 5 and 1 patient respectively). Young age (1-5y) at onset of disease and atopy were identified as an independent RISK FACTORS for RELAPSE (P<0.05). Patients with steroid dependent nephrotic syndrome (SDNS) or MCNS had better response to cyclophosphamide or cyclosporine than children with steroid resistance nephrotic syndrome (SRNS) or FSGS (P<0.05). Persistent proteinuria, hypertension, microscopic or macroscopic hematuia, glucosuria were associated with progression to chronic renal failure (P<0.05).Conclusion: Steroid dependency and histopathology of MCNS in patients with nephrotic syndrome were significantly associated with good long-term prognosis. In contrast persistent proteinuria, histopathology of FSGS, hypertension, macroscopic or microscopic hematuria, and glucosoria were significantly correlated with unfavorable LONG-TERM OUTCOME. Additionally our study showed a positive correlation between young age and atopy with higher rate of RELAPSE.

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APA: Copy

ATAEI, N., MADANI, ABAS, & FALAK ALAFLAKI, B.. (2003). EVALUATION OF CLINICAL COURSE, RIRSK FACTORS FOR RELAPSE AND LONG-TERM OUTCOME OF CHILDREN WITH PRIMARY NEPHROTIC SYNDROME. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), 61(4), 308-319. SID. https://sid.ir/paper/38372/en

Vancouver: Copy

ATAEI N., MADANI ABAS, FALAK ALAFLAKI B.. EVALUATION OF CLINICAL COURSE, RIRSK FACTORS FOR RELAPSE AND LONG-TERM OUTCOME OF CHILDREN WITH PRIMARY NEPHROTIC SYNDROME. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)[Internet]. 2003;61(4):308-319. Available from: https://sid.ir/paper/38372/en

IEEE: Copy

N. ATAEI, ABAS MADANI, and B. FALAK ALAFLAKI, “EVALUATION OF CLINICAL COURSE, RIRSK FACTORS FOR RELAPSE AND LONG-TERM OUTCOME OF CHILDREN WITH PRIMARY NEPHROTIC SYNDROME,” TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), vol. 61, no. 4, pp. 308–319, 2003, [Online]. Available: https://sid.ir/paper/38372/en

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