Identification of Disease and Drug-Related Complications and Associated Risk Factors in Patients with Childhood Idiopathic Nephrotic Syndrome

Abstract

Background Nephrotic syndrome is the most common glomerular disorder of childhood and data on complications are still limited and predisposing risk factors have not been fully defined. The aim of our study is to systematically evaluate treatment and disease-related acute and chronic complications, and to identify the risk factors involved in the development of complications.Methods This single center study was performed at the pediatric nephrology department of a tertiary pediatric hospital in Turkey. A total of 411 patients with a diagnosis of childhood idiopathic nephrotic syndrome, 128 of whom had the disease-releated and treatment-related complications, were included in the study. Patients diagnosed and followed up between January 2010 and January 2022 were evaluated retrospectively.Results Complications occurred in 31.1% of 411 children with childhood idiopathic nephrotic syndrome. The mean age at diagnosis was 7.54 ± 4.37 years, and the male to female ratio was 0.9. Ninety-six pount nine percent of complications were disease-related complications, and 50.8% were drug-related complications. Advanced age at diagnosis, female gender, a high of level of proteinuria, and a low estimated glomerular filtration rate level were determined as significant risk factors for complication development (p = 0.000, p = 0.006, p = 0.04, p = 0.07, respectively). Chronic kidney disease developed in 7% of patients and 2.9% of patients had end-stage renal failure. When the patients who progressed to end-stage renal disease were examined; compared with the control group, patients with complications had a significantly higher ESRD incidence (p < 0.05).Conclusions We hypothesized that closer and careful monitoring of patients at risk for complications and implementation of personalized treatment programs could improve long-term outcomes.