Clinical Course and Renal Function in Minimal Change Nephrotic Syndrome

Bohlin, Ann‐Britt

doi:10.1111/j.1651-2227.1984.tb09987.x

Cited by 14 publications

(5 citation statements)

References 15 publications

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“…In this series, diminished renal function was recorded in 22.5% of patients, typically aged over 60 years [23]. Similar findings have been found in other studies in adults and children [24,25,26,27]. Studies in children with NS have shown a close correlation of GFR alteration with both the reduced filtration fraction and the decreased serum albumin concentration that are relative to the severity of the nephrotic state.…”

Section: Frequency Of Aki In Patients With Nssupporting

confidence: 86%

Pathogenesis and Management of Acute Kidney Injury in Patients with Nephrotic Syndrome Due to Primary Glomerulopathies

2019

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Acute kidney injury in the context of nephrotic syndrome is a serious and alarming clinical problem. Largely, acute kidney injury is a relatively frequent complication among patients with comorbidities while it has been independently associated with an increased risk of adverse outcomes, including death and chronic kidney disease. Nephrotic syndrome, without hematuria or with minimal hematuria, includes a list of certain glomerulopathies; minimal change disease, focal segmental glomerulosclerosis and membranous nephropathy. In the light of primary nephrotic syndrome, pathophysiology of acute kidney injury is differentiated by the nature of the primary disease and the severity of the nephrotic state. This review aims to explore the clinical circumstances and pathogenetic mechanisms of acute kidney injury in patients with nephrotic syndrome due to primary glomerulopathies, focusing on newer perceptions regarding the pathogenesis and management of this complicated condition, for the prompt recognition and timely initiation of appropriate treatment in order to restore renal function to its baseline level. Prompt recognition of the precise cause of acute kidney injury is crucial for renal recovery. Clinical characteristics, laboratory and serological findings along with histopathological findings, if required, will reveal the implicated pathway leading to individualized approach and management.

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Section: Frequency Of Aki In Patients With Nssupporting

confidence: 86%

Pathogenesis and Management of Acute Kidney Injury in Patients with Nephrotic Syndrome Due to Primary Glomerulopathies

2019

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“…This finding has been shown in several previous studies that reported favorable outcome regarding kidney function in long-term follow-up of children with SSNS. [1][2][3][4][5][6][7][8][9][10][11] As in previous studies, the most common histopathological diagnosis was minimal change disease among those patients who had a kidney biopsy. Focal Segmental Glomerulosclerosis (FSGS) and Membranoproliferative Glomerulonephritis (MPGN) were observed less frequently in our cohort, accounting for only 9% and 3%, respectively.…”

Section: Discussionmentioning

confidence: 93%

“…In the literature to date, a number of studies have evaluated the long-term outcomes and kidney function in children with steroid-sensitive nephrotic syndrome (SSNS). [1][2][3][4][5][6][7][8][9][10][11] The largest study documenting long-term outcomes was the report of the International Study of Kidney Disease in Children (ISKDC) conducted during the 1960s and 1970s. The results of this study showed that that there is a negligible risk for developing chronic kidney disease or other adverse outcomes in children who are steroid sensitive after a mean follow-up period of 9.4 years.…”

Section: Introductionmentioning

confidence: 99%

Glomerular Filtration Rate Trends During Follow-up in Children With Steroid-Sensitive Nephrotic Syndrome

Alsaidi

Wagner

Grisaru

et al. 2017

Can J Kidney Health Dis

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Background:Overall prognosis of children with steroid-sensitive nephrotic syndrome (SSNS) is regarded as generally favorable. However, only a few recent studies have evaluated changes in kidney function and blood pressure over time in children with SSNS.Objectives:We describe clinical features of SSNS patients and characterize changes in calculated estimated glomerular filtration rate (eGFR) and use of antihypertensive medications during follow-up.Design:This is a retrospective cohort study.Setting:This study was conducted in a Canadian pediatric nephrology center.Patients:This study included patients aged 1 to 18 years with SSNS.Measurements:eGFR was calculated from recorded serum creatinine and height measurements using the modified Schwartz equation.Methods:eGFR was calculated at yearly intervals, and the trend of eGFR was assessed using linear mixed effects model. Patients were also evaluated for use of antihypertensive medications during follow-up.Results:Seventy-eight patients—median age, 3.2 years (interquartile range [IQR], 2.65) and median follow-up of 4.37 (IQR, 5.6)—were evaluated. Sixty-three (80.8%) had at least 1 relapse. Twenty-two (28.2%) and 20 (25.6%) were steroid dependent and frequently relapsing, respectively. Forty-three patients (55.1%) received at least 1 steroid-sparing agent, and of these, 18 (41.8%) received a calcineurin inhibitor. One patient had eGFR ≤90 mL/min/1.73 m2 during observation. eGFR remained unchanged over the follow-up period in this cohort of patients. Four patients (5.1%) were on antihypertensive medications at the end of follow-up.Limitations:Patients who had frequent relapses had more measurements available for serum creatinine and height, creating a sampling bias. The number of eGFR measurements was overall small, making it difficult to ascertain eGFR trend.Conclusion:eGFR remained unchanged over time in this cohort, and a small proportion of patients required antihypertensive therapy at the end of follow-up. Our study highlights the needs for carefully constructed long-term observational studies of children with nephrotic syndrome.

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“…The renal dysfunction in NS is generally reversible. Bohlin reported impaired glomerular filtration rate (GFR) by inulin clearance at onset of nephrotic syndrome in six out of 13 children (19). The clinical course of these children did not differ from that of the others over a follow up of 1–7 years, and none had a decreased GFR later in the course of the disease.…”

Section: Pathophysiology Of Akimentioning

confidence: 99%

Acute Kidney Injury in Nephrotic Syndrome

Menon

2019

Front. Pediatr.

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Nephrotic syndrome (NS) is one of the commonest kidney diseases seen in childhood and is characterized by a relapsing remitting course. Various complications have been reported in children with NS, including infections, thromboembolism, hypovolemia, and acute kidney injury (AKI). There is often a modest decrease in renal function in patients with active proteinuria due to decreased glomerular permeability that improves when they go into remission. However, more pronounced AKI in NS is multifactorial in origin. It is most often secondary to hypovolemia, nephrotoxic medications, and infections, although other reasons may also be seen. Recent years have seen an increase in the incidence of AKI in NS. There is limited data on the correlation between AKI in pediatric NS and long-term outcomes. A better understanding of this increasingly common condition will help improve patient outcomes.

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Clinical Course and Renal Function in Minimal Change Nephrotic Syndrome

Cited by 14 publications

References 15 publications

Pathogenesis and Management of Acute Kidney Injury in Patients with Nephrotic Syndrome Due to Primary Glomerulopathies

Pathogenesis and Management of Acute Kidney Injury in Patients with Nephrotic Syndrome Due to Primary Glomerulopathies

Glomerular Filtration Rate Trends During Follow-up in Children With Steroid-Sensitive Nephrotic Syndrome

Acute Kidney Injury in Nephrotic Syndrome

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