Steroid sensitive nephrotic syndrome in children: Frequency of relapse during the first twelve months after completion of six months steroid therapy.

Abstract

Objectives: Nephrotic syndrome (NS) is described as the existence of nephrotic-range proteinuria along with edema, hyperlipidemia and hypoalbuminemia. NS is estimated to be 15 time more frequent in children as compared to adults. Relapse is a major problem while managing nephrotic children. This study was aimed to find out the frequency of relapse in children with first episode of steroid sensitive nephrotic syndrome (SSNS) during the first 12 months, after completion of 6 months steroid therapy. Study Design: Descriptive case series study. Setting: Department of Paediatric Nephrology, The Children’s Hospital & the Institute of Child Health, Multan. Period: From February 27, 2018 to February 27, 2019. Material and Methods: A total of 55 children, aged 1 to 10 years, diagnosed with SSNS, 1^st presentation of NS (based on history) and who successfully completed 6 months steroid therapy, were enrolled. They were taught to check proteinuria at home by dipstick method and enter daily results on the follow up card provided from the Nephrology department of the hospital. The outcome variable, that is relapse, was noted on the Proforma. Results: Amongst 55 children, gender distribution showed 38 (69.1%) male and 17 (30.9%) females. Children with body weight <20 kg were 33 (60%) and those having ≥20kg were 22 (40%).  Patients with age <6 years were 54.5% and patients with age ≥6 years were 45.5%. Mean age was 5.93± 3.36 years. Frequency of relapse was noted to be 78.2% and patients who did not relapse within 1 year of completion of treatment were 21.8%. Conclusion: Nephrotic syndrome is a common presentation of childhood renal problems and is major cause of morbidity in our set up. Relapses are frequently associated with SSNS and most of the patients relapse within 1 year of completion of treatment. Relapses are more common in male children as compared to female children.