Treatment Outcomes of Pediatric Nephrotic Syndrome Patients Treated in Ayder Comprehensive Specialized and Mekelle General Hospitals, Ethiopia.

IF 2.1 Q2 UROLOGY & NEPHROLOGY

International Journal of Nephrology and Renovascular Disease Pub Date : 2021-05-24 eCollection Date: 2021-01-01 DOI:10.2147/IJNRD.S310567

Yainu Welegerima, Mamo Feyissa, Teshome Nedi

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引用次数: 5

Abstract

Background: Nephrotic syndrome is a common glomerular disease in children with a relapsing course that leads to complications and steroid-related toxicities. In Ethiopia, data on the outcomes of steroid therapy in pediatric nephrotic syndrome patients are limited.

Objective: The aim of the study was to assess the treatment outcomes of pediatric nephrotic syndrome patients in Ayder Specialized Comprehensive and Mekelle General Hospitals.

Methods: A retrospective study was conducted among children treated for nephrotic syndrome from 2010 to 2017 in Ayder Comprehensive Specialized and Mekelle General Hospitals. Univariate and multivariate logic regression analyses were performed to identify determinants of treatment outcome with a p-value <0.05 considered statistically significant.

Results: A total of 159 pediatric patients treated for nephrotic syndrome in both hospitals were included in this study. The mean age of participants at the initial diagnosis was 5.21 ± 2.66 years. Most of the patients 150 (94.3%) achieved remission within 4 weeks of steroid therapy. Among initial responders, the majority of the patients 117 (78%) encountered relapses of which 65 (40.9%) were developed frequent relapse/steroid-dependent nephrotic syndrome. Also, the majority of patients 102 (64.5%) encountered steroid-related toxicities. The predictors of frequent relapse/steroid-dependent nephrotic syndrome were age of ≤6 years (AOR=3.16; p=0.00), hematuria (AOR=6.74; p=0.00), infection (AOR=3.28; p=0.01), acute renal failure (AOR=6.09; p=0.01), serum albumin below 1.5g/dl (8.38, p=0.01) and lack of remission within 2 weeks (AOR=3.69; p=0.00).

Conclusion: Most of the pediatric NS patients treated in ACSH and MGH have achieved remission with initial to steroid therapy. However, there was a higher relapse rate and steroid-related toxicities among pediatric NS patients who achieved remission. Early age at diagnosis, hematuria, reduced GFR, infection, and remission time were the independent predictors of the frequent relapsing/steroid-dependent nephrotic disease course.

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埃塞俄比亚Ayder综合专科医院和Mekelle综合医院儿科肾病综合征患者的治疗效果

背景:肾病综合征是儿童常见的肾小球疾病，其复发过程可导致并发症和类固醇相关毒性。在埃塞俄比亚，关于儿童肾病综合征患者类固醇治疗结果的数据有限。目的:本研究的目的是评估在Ayder专科综合医院和Mekelle综合医院儿科肾病综合征患者的治疗效果。方法:对2010 - 2017年在艾德尔综合专科医院和梅克尔综合医院就诊的肾病综合征患儿进行回顾性研究。采用单因素和多因素逻辑回归分析，以p值确定治疗结果的决定因素。结果:本研究共纳入159名在两家医院接受肾病综合征治疗的儿童患者。患者初诊时的平均年龄为5.21±2.66岁。大多数患者150例(94.3%)在类固醇治疗4周内达到缓解。在最初应答者中，117例(78%)患者出现复发，其中65例(40.9%)出现频繁复发/类固醇依赖性肾病综合征。此外，大多数患者102(64.5%)出现类固醇相关毒性。频繁复发/类固醇依赖性肾病综合征的预测因素为:年龄≤6岁(AOR=3.16;p=0.00)、血尿(AOR=6.74;p=0.00)，感染(AOR=3.28;p=0.01)，急性肾功能衰竭(AOR=6.09;p=0.01)，血清白蛋白低于1.5g/dl (8.38, p=0.01)， 2周内无缓解(AOR=3.69;p = 0.00)。结论:大多数接受ACSH和MGH治疗的儿童NS患者通过初始到类固醇治疗均获得缓解。然而，在获得缓解的儿童NS患者中，复发率和类固醇相关毒性较高。诊断年龄早、血尿、GFR降低、感染和缓解时间是频繁复发/类固醇依赖性肾病病程的独立预测因素。

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来源期刊

International Journal of Nephrology and Renovascular Disease UROLOGY & NEPHROLOGY-

CiteScore

3.90

自引率

5.00%

发文量

审稿时长

16 weeks

期刊介绍： International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.