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Average length of stay in hospital for patients in different age groups at initial onset of NS, n = 344
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Abstract Background Nephrotic syndrome (NS) is one of the most frequent occurring chronic kidney diseases in childhood, despite its rarely occurrence in the general population. Detailed information about clinical data of NS (e.g. average length of stay, complications) as well as of secondary nephrotic syndrome (SNS) is not well known. Methods A nat...
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Context 1
... the present study, children less than 3 years of age stayed significantly longer in hospital at onset than older children, most likely due to the higher rate of bacterial infections. Interestingly, the ALOS increased for children over 12 years of age (Fig. 3) possibly due to the fact, that the complication rate in this age group is higher com- pared to the other age groups. Furthermore, the ALOS of girls was 16.0 days slightly compared to boys with 15.0 days, although girls were more likely to have SRNS and FSGS. Schlesinger et al. also examined the length of stay in hospital for patients ...
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Citations
... [1] In Western Europe, the reported yearly incidence varies between 1.2 and 3.5 per 100,000 children. [2][3][4] Its prevalence is 4.7 per 100,000 per year worldwide with newly affected cases 1-2 per 10,000 per year worldwide [5] and up to 6.5 per 100,000 per year in Japan. [6] Corticosteroids are an effective treatment for 80%-85% of children with NS; nevertheless, 10%-15% of these children continue to be refractory to treatment or develop steroid resistance (SR) over time. ...
... These two phenomena were associated with severe malnutrition constituting a factor of poor prognosis on the evolution of the nephrotic syndromes towards [20]. Anemia and malnutrition were frequently observed in our patients. ...
... It has also been reported in earlier Nigerian studies that NS was more common in men than in women (Asinobi et al., 2005;Anochie et al., 2016;Ladapoet al., 2019). In addition, the male to female ratio of 1.78:1 obtained in the current study was higher, similar and lower to those reported in some earlier studies (Safaei and Maleknejad, 2009;Alhassan et al., 2013;Varshney et al. 2015;Chang et al., 2016). The rationale to our finding may be due to a more rapid disease progression in male children. ...
Nephrotic syndrome (NS) is a complex kidney disease associated with numerous complications which can subsequently lead to cardiovascular disease among others. This study was aimed at assessing the lipid profile, serum and urinary proteins of patients with Nephrotic syndrome (NS) in Kano metropolis. A total of 50 NS patients and 25 apparently healthy volunteers(controls) were recruited for the study, made up of 32 males and 18 females with the age range of 4-70 years. Blood and urine sample were collected from the participants. Serum urea and creatinine were determined using urease berthelot’s reaction and Alkaline picrate methods. Serum total protein and albumin were assayed using Biuret and bromocresol green binding method through the manual colorimetrictechnique. Serum lipid profile were measured by an enzymatic spectrophotomeric method and the precipitation enzymatic method was specifically used for evaluating the levels of high-density lipoprotein cholesterol (HDL-C). Urine protein was determined using sulphur salicylic acid test. SPSS software package version 21 was used for the analysis of data. High frequency of NS of 40(80%) was observed in patients of <18 years while patient of >46 years had a lower frequency of 4(8%). Males recorded higher frequency of 32(64%) and the frequency of NS among females was 18(36%), thus the male to female ratio for NS was 1.78:1. The mean values of serum creatinine, urea, urinary protein (UP), total cholesterol (T.C), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), T.C/HDL-C, TG/HDL-C, LDL/HDL-C ratio were significantly higher (p<0.05) in patients with NS than the healthy volunteers. Total protein (TP), albumin (Alb), globulin, HDL-C ratio were significantly lower (p<0.05) in NS when compared to healthy volunteers. There was positive correlation between UP and TC, TG and LDL, however, negative correlation was observed between UP and HDL-C with no statistical significance. Dyslipidemia, decreased serum protein and increase serum creatinine, Urea as well as UP were associated with NS. In conclusion, lipid profile and UP analysis may be a useful tool for diagnosis of NS and early diagnosis can reduce the disease morbidity.
... children annually, while it is 3-3.5/100,000 children annually in France and 6.48/100,000 children in Japan [4], [5], [6]. Its prevalence in Indonesia is 6/100,000 children with male to female ratio ranges from 2:1 to 3:2. ...
... Only 5% of patients develop end-stage renal disease [5], [6], [13]. Several complications following nephrotic syndrome are infections such as peritonitis and pneumonia, thromboembolism, kidney injury, and dyslipidemia [4], [6], [8], [14]. ...
BACKGROUND: Nephrotic syndrome is the most common glomerular disease in children with high economic burden. The management of nephrotic syndrome at present is not only focusing in outcomes of disease but also the burden related to health-related quality of life (HRQOL). HRQOL of children with nephrotic syndrome is influenced by steroid dependence, steroid resistance, cytotoxic therapy, frequency of relapse, disease severity, socioeconomic status, and duration of illness. AIM: The objective of the study is to determine the difference of HRQOL in children between early diagnosed nephrotic syndrome and finished therapy of nephrotic syndrome. METHODS: A cross-sectional study was conducted between January and December 2018. Subjects were children aged 1–18 years with nephrotic syndrome and then divided into 2 groups based on either in the 1st week of full dose corticosteroid treatment or in the 1st week after finishing therapy equally. Demographical data, nutritional status, and laboratory results were obtained. HRQOL was measured using PedsQL 4.0 questionnaire in the Indonesian language. The difference of HRQOL was analyzed using independent T-test. RESULTS: A total of 100 subjects enrolled in this study and divided into two groups. Male-to-female ratio was 4:1 in early diagnosed group and 7.3:1 in finished therapy group. Mean age of subjects for the early diagnosed group was 4.6 years and finished therapy group was 5.3 years. Total HRQOL was improved after treatment administration in children with nephrotic syndrome (p < 0.001). The improvement was most significant in physical domain (p = 0.002). CONCLUSION: HRQOL in children with early diagnosed nephrotic syndrome was lower compared to children with finished therapy of nephrotic syndrome.
... It has also been reported in earlier Nigerian studies that NS was more common in men than in women (Asinobi et al., 2005;Anochie et al., 2016;Ladapo et al., 2019). In addition, the male to female ratio of 1.78:1 obtained in the current study was higher, similar and lower to those reported in some earlier studies (Safaei and Maleknejad, 2009;Alhassan et al., 2013;Varshney et al. 2015;Chang et al., 2016). The rationale to our finding may be due to a more rapid disease progression in male children. ...
... children aged under 16 [1]. The reported annual incidence in children varies between 1.2 and 3.5 per 100.000 per year in Western Europe [2][3][4], 4.7 per 100.000 per year worldwide [5] and up to 6.5 per 100.000 per year in Japan [6]. NS is characterized by the triad of heavy proteinuria, hypoalbuminemia (≤2.5 g/ dL), and generalized edema. ...
Background: Cytokines are functional class of tiny proteins and glycoprotein and fundamentally they are monomers that function as soluble mediators
in an autocrine or paracrine manner. Cytokines are produced by a number of cell types, predominantly leukocytes, and their targets implicate both
immune and non-immune cells.
Material and methods: This study was performed on 75 children with glomerulonephritis (GN), aged from 2 up to 17 years. There were 20 children with
steroid-sensitive nephrotic syndrome (SSNS), 15 children with steroid-resistant nephrotic syndrome (SRNS), 20 children with chronic glomerulonephritis
(CGN) nephrotic form and 20 children with CGN mixed form. This study was performed on patients experiencing disease relapse and clinical remission.
The control group consisted of 20 healthy children.
Results: The results of this study demonstrated increased levels of cell signaling molecules (IL-8, TNF-α, MCP-1, MIP-1α) in the urine during clinical
manifestations, valuable result due to their major role in the immunopathogenic mechanism of proteinuria in nephrotic syndrome.
Conclusions: Determination of urinary concentrations of cellular signaling molecules may be useful as a predictive non-invasive method for estimating
disease activity, monitoring disease progression, differentiating steroid-sensitive nephrotic syndrome from steroid-resistant nephrotic syndrome, and
assessing the effectiveness of treatment in children with different variants of GN.
... The prevalence is 12-16 per 100,000 children aged under 16 [1]. The reported annual incidence in children varies between 1.2 and 3.5 per 100,000 per year in Western Europe [2][3][4], 4.7 per 100,000 per year worldwide [5] and up to 6.5 per 100,000 per year in Japan [6]. Although more than 85% of children with nephrotic syndrome respond to corticosteroids, approximately 10-15% remain unresponsive or later become steroid-resistant [7][8][9][10][11]. ...
Steroid-resistant nephrotic syndrome (SRNS) remains a challenge for paediatric nephrologists. SRNS is viewed as a heterogeneous disease entity including immune-based and monogenic aetiologies. Because SRNS is rare, treatment strategies are individualized and vary among centres of expertise. Calcineurin inhibitors (CNI) have been effectively used to induce remission in patients with immune-based SRNS; however, there is still no consensus on treating children who become either CNI-dependent or CNI-resistant. Rituximab is a steroid-sparing agent for patients with steroid-sensitive nephrotic syndrome, but its efficacy in SRNS is controversial. Recently, several novel monoclonal antibodies are emerging as treatment option, but their efficacy remains to be seen. Non-immune therapies, such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, have been proven efficacious in children with SRNS and are recommended as adjuvant agents. This review summarizes and discusses our current understandings in treating children with idiopathic SRNS.
Background:
Nephrotic syndrome (NS) is the most common pediatric chronic kidney disease characterized by massive proteinuria, hypoalbuminemia, edema, and hyperlipidemia. Corticosteroids, as the mainstay of treatment, resolve symptoms in most patients. However, some patients experience a relapsing-remitting course. Currently, there is no specific biomarker for the prediction of steroid response in patients with NS. The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are inexpensive readily accessible parameters that are proved to be related to the inflammatory state in many disorders.
Method:
We evaluated NLR and PLR ratios before and after steroid therapy in 50 pediatric patients with NS in a single pediatric referral center. Data analysis was carried out using SPSS software and the significance level was considered as 0.05.
Results:
Medical response to steroid was compatible with steroid-dependent (SD) nephrotic syndrome (NS) in 30% (n=15), steroid-resistant (SR) NS in 12% (n=6), steroid-sensitive (SS) NS in 36% (n=18), and frequently relapsing (FR)NS in 22% (n=11). Fourteen patients (29.2%) did not experience recurrence. Before and after steroid therapy, the mean PLRs were 10.9 and 11.7 and the mean NLRs were 1.9 and 2.2, respectively, which were not statistically different (P>0.05).
Conclusion: We do not recommend NLR and PLR as predictors of steroid response in pediatric patients with NS.
