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Year : 2023  |  Volume : 8  |  Issue : 1  |  Page : 24-29

Response pattern and risk factor of relapse in children with first attack idiopathic nephrotic syndrome

Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Correspondence Address:
Dr. Shamsun Nahar Shanta
Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pnjb.pnjb_24_22

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Background: Most patients with idiopathic steroid-sensitive nephrotic syndrome have frequent relapses. So, it is very important to find out such children who are prone to develop frequent relapses. The objective of this study is to find out the predictors of relapse. Materials and Methods: This prospective longitudinal study was carried out in the Department of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from September 2015 to August 2016. A total of 110 patients of idiopathic nephrotic syndrome (INS) with the initial attack, aged 1–18 years, were enrolled in this study. All patients were treated with prednisolone 60 mg/m2/day, single morning dose for 6 weeks, followed by 40 mg/m2 every alternate day for another 6 weeks. Among 110 patients, seven patients were lost during follow-up, and six patients were excluded from this study due to unresponsive to oral prednisolone 60 mg/m2/day within 4 weeks. The remaining 97 were analyzed and followed up. Results: Among them, 59 (60.9%) were males, 38 (39.1%) were females, with a male:female ratio of 1.5:1. Twenty-nine (29.9%) children had no relapse, 24 (24.7%) had infrequent relapse, and 44 (45.3%) had frequent relapse. Children responding between 2 and 4 weeks after the start of treatment had a more chance of relapse (P = 0.002) than those who responded less than 1 week. Children with INS who had respiratory tract infection at onset had 4.4 times more chance of relapse. Children with low serum albumin (<15 g/L) at onset had 2.1 times more chance of relapse. Conclusions: There was significant correlation of INS associated with male sex, delayed response to steroid treatment, respiratory tract infection at onset, and severe hypoalbuminemia with more relapse.

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