Marina Vivarelli1, Eleonora Moscaritolo1, Aggelos Tsalkidis2, Laura Massella1, Francesco Emma1. 1. Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy. 2. Department of Pediatrics, University Hospital of Alexandroupolis, Democritus University of Thrace-Medical School, Alexandroupolis, Greece.
Abstract
OBJECTIVE: To identify early prognostic factors for idiopathic nephrotic syndrome (INS) in childhood. STUDY DESIGN: A retrospective analysis of 103 patients with INS at onset, all treated in a single center with the same induction protocol, was conducted. Minimum length of follow-up was 2 years; median length of follow-up was 43 months. Survival data were assessed with Cox-Mantel analysis. Predictive values were estimated with receiver operating characteristic curves. RESULTS: The median time of response to steroid therapy was 7 days. A significant association was found between the interval from onset of steroid therapy to remission and the risk of relapsing within 3 months after steroid therapy discontinuation (P < .0001). A similar association was found between the time to achieve remission and the risk of developing frequent relapsing or steroid-dependent nephrotic syndrome (P < .0001), the prescription of maintenance steroid therapy (P < .003), and the prescription of all other non-steroid drugs (P < .0001) during follow-up. Patients with non-relapsing and infrequent relapsing nephrotic syndrome had a median time to achieve remission <7 days; in patients with frequent relapsing and steroid-dependent nephrotic syndrome, this median was >7 days. CONCLUSION: The interval from onset of steroid therapy to remission is an accurate early prognostic factor in INS. Copyright 2010 Mosby, Inc. All rights reserved.
OBJECTIVE: To identify early prognostic factors for idiopathic nephrotic syndrome (INS) in childhood. STUDY DESIGN: A retrospective analysis of 103 patients with INS at onset, all treated in a single center with the same induction protocol, was conducted. Minimum length of follow-up was 2 years; median length of follow-up was 43 months. Survival data were assessed with Cox-Mantel analysis. Predictive values were estimated with receiver operating characteristic curves. RESULTS: The median time of response to steroid therapy was 7 days. A significant association was found between the interval from onset of steroid therapy to remission and the risk of relapsing within 3 months after steroid therapy discontinuation (P < .0001). A similar association was found between the time to achieve remission and the risk of developing frequent relapsing or steroid-dependent nephrotic syndrome (P < .0001), the prescription of maintenance steroid therapy (P < .003), and the prescription of all other non-steroid drugs (P < .0001) during follow-up. Patients with non-relapsing and infrequent relapsing nephrotic syndrome had a median time to achieve remission <7 days; in patients with frequent relapsing and steroid-dependent nephrotic syndrome, this median was >7 days. CONCLUSION: The interval from onset of steroid therapy to remission is an accurate early prognostic factor in INS. Copyright 2010 Mosby, Inc. All rights reserved.
Authors: Premala Sureshkumar; Elisabeth M Hodson; Narelle S Willis; Federica Barzi; Jonathan C Craig Journal: Pediatr Nephrol Date: 2014-02-02 Impact factor: 3.714
Authors: Andrea Pasini; Cristina Bertulli; Luca Casadio; Ciro Corrado; Alberto Edefonti; GianMarco Ghiggeri; Luciana Ghio; Mario Giordano; Claudio La Scola; Cristina Malaventura; Silvio Maringhini; Antonio P Mastrangelo; Marco Materassi; Francesca Mencarelli; Giovanni Messina; Elena Monti; William Morello; Giuseppe Puccio; Paola Romagnani; Giovanni Montini Journal: Front Pediatr Date: 2021-07-08 Impact factor: 3.418