Risk factors for relapse in pediatric nephrotic syndrome

Main Article Content

Husein Albar
Fadel Bilondatu
Dasril Daud

Abstract

Background Nephrotic syndrome (NS) is the most common kidney disease in children and is characterized by edema, massive proteinuria, hypoalbuminemia, and hyperlipidemia. High relapse rate remains a major problem in the management of this syndrome.


Objective To identify risk factors for relapse in pediatric nephrotic syndrome.


Methods This study was carried out in the Wahidin Sudirohusodo Teaching Hospital in Makassar, South Sulawesi, Indonesia, from January to August 2017 using complete medical records of children diagnosed with NS. Subjects were divided into 2 groups: 1) relapsed NS or 2) non-relapsed NS.  The following potential risk factors for relapse were analyzed using Chi-square test: age, sex, nutritional status, hypertension, serum creatinine level, and infection at the time of established diagnosis of NS.


Results A total of 142 children with NS who fulfilled the inclusion criteria aged 1.4 to 17.5 years were included in the study. Subjects were mostly boys (66.2%), with a male: female ratio of 1.95:1. The relapsed NS group had 80 cases (56.3%) and the non-relapsed NS group had 62 cases (43.7%). Statistical analysis revealed that nutritional status was a significant risk factor for relapse in pediatric nephrotic syndrome (P<0.05).


Conclusion Nutritional status is an independent risk factor for relapse in pediatric nephrotic syndrome. 

Article Details

How to Cite
1.
Albar H, Bilondatu F, Daud D. Risk factors for relapse in pediatric nephrotic syndrome. PI [Internet]. 4Oct.2018 [cited 22Nov.2018];58(5):238-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1890
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References

1. The International Study of Kidney Disease in Children (ISKDC). Early identification of frequent relapser among children with minimal change nephrotic syndrome. J Pediatr. 1982:101:514-8
2. Wila Wirya IGN: Penelitian beberapa aspek klinis dan patologi anatomis sindrom nefrotik primer pada anak di Indonesia. Disertasi, FKUI. Jakarta 14 Oktober 1992.
3. Trihono PP, Alatas H, Tambunan T, Pardede SO, Noer, MS, Soemyarso N. Kompendium nefrologi anak. Jakarta: BP IDAI; 2012. p. 72-80.
4. Pais P, Avner ED. nephrotic syndrome. In: Kliegman RM, Stanton BF, Geme JW, Schor NF BR, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier Ltd; 2016. p. 2521.
5. Sarker MN, Islam M, Saad T, Shoma FN, Sharmin LS, Khan HA, et al. Risk factor for relapse in childhood nephrotic syndrome - a hospital based retrospective study. Faridpur Med Coll J. 2012;7:18–22.
6. Constantinuescu AR, Shah HB, Foote EF, Weiss LS. Predicting first-year relapses in children with nephrotic syndrome. Pediatrics. 2000;105:492–5.
7. Mishra OP, Abhinay A, Mishra RN, Prasad R, Pohl M. Can we predict relapses in children with idiopathic steroid-sensitive nephrotic syndrome? J Trop Pediatr. 2013;59:343-9.
8. Subandiyah K. Outcome sindrom nefrotik pada anak – penelitian prospektif studi cohort. Jurnal Kedokteran Brawijaya. 2004:20;3: 150-1.
9. Ali SH, Twfeek ZA, Azat NFA, Hasan AA. Triggering factors for relapses in steroid sensitive nephrotic syndrome. Int J Curr Microbiol App Sci. 2016;5:842–51.
10. Situmorang D, Sekarwana N, Fadlyana E. Risk factor of frequent relapse in pediatric nephrotic syndrome. Am J Med Biol Res. 2016;4:10–2.
11. Andersen RF, Thrane N, Noergaard K, Rytter L, Jespersen B, Rittig S. Early age at debut is a predictor of steroid-dependent and frequent relapsing nephrotic syndrome. Pediatr Nephrol. 2010;25:1299-304.
12. Matar RB, Valentini RP, Smoyer WE. Primary podocytopathies. In: Kher KK, Schnaper HW, Greenbaum LA, eds. Clinical Pediatric Nephrology. 3rd edition. Boston: CRC Press 2017. p. 307-9.
13. Naibaho RM, Susanto RD, Tambunan T. Kekambuhan dini sebagai petanda prognosis kurang baik pada sindrom nefrotik - Laporan kasus. Maj Kedokt Indon. 2009;59:halaman? .
14. Sudiharjo W, Prasetyo RV, Umijati S. Clinical profile of children with steroid-sensitive idiopathic nephrotic syndrome relapsing in the first year at dr. Soetomo hospital, Surabaya. Folia Medica Indonesiana. 2012;48:180-5.
15. Wisata L, Prasetyo D, Hilmanto D. Perbedaan aspek klinis sindrom nefrotik resisten steroid dan sensitif steroid pada anak. Maj Kedokt Indon. 2010:60;12: 561-2.