Prognostic factors and survivals of children with steroid-resistant nephrotic syndrome
AbstractBackground Children with steroid resistant nephrotic syndrome
(SRNS) generally survive, although during the course of disease
their kidney function may decrease, leading to end-stage renal
disease (ESRD). There have been few studies reporting on the
survivals of children with SRNS.
Objectives To determine patient and kidney survival rates in children
with SRNS at the first, second, third, fourth, and fifth years; and to
evaluate the effects of age at onset, initial kidney function, hypertension,
and type of resistance, on the survivals of children with SRNS.
Methods This retrospective cohort study was performed using
secondary data obtained from medical records of patients with SRNS in
Department of Child Health, Cipto Mangunkusumo Hospira~ between
2004-2011. The outcomes of kidney survivals were defined in two ways:
lack of doubling of base creatinine levels and lack of ESRD.
Results There were 45 children with SRNS in our study. Their median
duration ofillness was 24 (range 12-95) months. Twenty percent of the
subjects died, 31.1 % had a doublingofbase creatinine levels, and 13.4%
developed ESRD. Life survival rates of subjects at the first, second,
third, fourth, and fifth years after diagnosis were 93 %, 84%, 80"/ri, 7 2%
,and 61 %, respectively. Kidney survival rates determined by the lack
of doubling of base creatinine levels at the first, second, third, fourth
and fifth years were 92%, 72%, 56%, 42%, and 34%, respectively, while
kidney survival rates determined by the lack ofESRD were 97%, 88%,
81 %, 70"/o, and 58%, respectively. Age at onset, initial kidney function,
hypertension at onset, and type of resistance, did not significantly affect
the survivals of children with SRNS.
Conclusion Children with SRNS are prone to develop a doubling
of base creatinine levels and ESRD. Factors such as age, initial
kidney function, hypertension at onset, and type ofresistance, do
not significantly affect both, life and kidney survivals of children
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