Original Articles
To assess the risk variables associated with recurrence in pediatric nephrotic syndrome | |
Dr. Amandeep Kaur, Dr. Aanshul Rai Gupta, Dr. Nikhil Arora | |
Background: Nephrotic syndrome (NS) is the predominant renal disorder in children and is distinguished by edema, extensive proteinuria, low levels of albumin, and elevated lipid levels. The therapy of this disease continues to face a significant challenge due to a high recurrence rate. Aim: To assess the risk variables associated with recurrence in pediatric nephrotic syndrome. Material and methods: We examined 100 children admitted to the hospital with NS. Patients who met the ISKDC criteria for the diagnosis of NS, which includes having excessive protein in the urine (proteinuria >40 mg/m2/hour or 50mg/kg/day; urinary protein/creatinine ratio >2.0; or dipstick ≥ 2+), low levels of albumin in the blood (serum albumin < 2.5 g/dL), swelling, and high levels of cholesterol in the blood (serum cholesterol >200 mg/dL), were subjected to further analysis. Relapse was defined as the presence of urine protein at a level of 2+ or higher (or proteinuria above 40 mg/m2/hour) for three days within a week. Results: The average age was 9.15±1.76 years. It was observed that 55% of the patients had a normal nutritional condition, 75% had normal blood pressure, and 64% showed no signs of infection at the time of diagnosis. The laboratory findings indicated that most patients (90%) had normal creatinine levels, whereas over half (52%) showed hematuria. The chi-square test indicated that there was no statistically significant disparity in terms of gender or age between the two groups. No statistically significant differences were seen between the relapsed and non-relapsed groups in terms of hypertension, infection, serum creatinine level, or hematuria. Nevertheless, a notable disparity in the nutritional condition of the participants was identified between the relapsed and non-relapsed groups, with a statistically significant difference (P=0.01). Conclusion: Ultimately, the nutritional condition of children at the moment of diagnosis might serve as a risk factor for the recurrence of juvenile nephrotic syndrome. If the patient with NS is malnourished, clinicians should provide nutritional treatment and reassess the patient's condition at least six months after receiving steroid medication. |
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