Clinical Predictors of Steroid Resistance in Childhood Nephrotic Syndrome.

Cicek, Neslihan; Yıldız, Nurdan; Guven, Sercin; Kaya, Mehtap; Gokce, Ibrahim; Alpay, Harika

We aimed to evaluate the clinical parameters, histopathological findings of nephrotic syndrome (NS) patients, and independent factors predicting steroid resistance in a single tertiary center. One hundred and sixty-two children (57 girls and 105 boys) with NS who were followed between 1998 and 2018 were analyzed in this retrospective cohort. The median (interquartile range; range) age and follow-up time were 4.9 (5.7; 0.1-16.8) and 5.5 (5.4; 0.1-20.3) years. A total of 82.7% of the patients were steroid-sensitive nephrotic syndrome (SSNS) and 17.3% were steroid-resistant nephrotic syndrome (SRNS). The median age at first presentation was lower in the SSNS group (P =.002). The most common histopathological findings were focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD). Hypertension and macroscopic and microscopic hematuria were higher in the SRNS group (P <.001). The age and microscopic hematuria were independent risk factors for steroid resistance (P =.019 and P =.002, respectively). Complement 3 (C3) was evaluated in 148 patients and found low in 7 patients who were subsequently diagnosed as membranoproliferative glomerulonephritis. There is still no better clinical predictor for steroid response than late age of onset and microscopic hematuria. Hypertension may also give a hint for potential steroid resistance.

STEROID drugs; STEROIDS; PREDICTION models; QUESTIONNAIRES; HYPERTENSION; TERTIARY care; RETROSPECTIVE studies; HEMATURIA; FOCAL segmental glomerulosclerosis; NEPHROTIC syndrome in children; NEPHROTIC syndrome; LONGITUDINAL method; HISTOLOGICAL techniques; MEDICAL records; ACQUISITION of data; DRUG resistance; CHILDREN

Clinical Pediatrics, 2024, Vol 63, Issue 9, p1300

0009-9228

Academic Journal

10.1177/00099228231219109