Timing and predictive factors of developing chronic kidney disease in childhood-onset idiopathic nephrotic syndrome: an Asian experience

Idris, Siti Salamah Mohd; Nasir, Ariffin; Ismail, Nik Zainal Abidin Nik; Rostenberghe, Hans Amin Van; Ilias, Mohamad Ikram

doi:10.11622/smedj.2019096

Cited by 3 publications

(3 citation statements)

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“…As compared to the patients without complications, those with complications had a significantly higher incidence of ESRD. These rates are also higher than in earlier studies in INS, which reported a CKD prevalence of 3%-10% and an ESRD prevalence of 3.6% during a mean follow-up of 7.70 ± 3.81 years [30]. It supports the conclusion that the development of CKD and ESRD is more common in patients with complications.…”

Section: Discussionsupporting

confidence: 79%

Complications Related to Childhood Idiopathic Nephrotic Syndrome, Its Treatment and the Associated Risks in Patients

Karakaya,

Güngör,

Kargın Çakıcı

et al. 2023

Cureus

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Aim Nephrotic syndrome is the most common childhood glomerular disorder, but data on the associated complications are limited and predisposing risk factors have not been fully defined. The aim of this study was to evaluate disease- and treatment-related acute and chronic complications in patients with childhood idiopathic nephrotic syndrome (INS), 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. The study included 411 patients with a diagnosis of childhood INS, 128 of whom had disease-related and treatment-related complications. Patients diagnosed and followed-up between January 2010 and January 2022 were evaluated retrospectively. Results Complications occurred in 31.1% of the 411 patients. Mean age at the time of diagnosis was 7.54 ± 4.37 years, and the male/female ratio was 0.9:1. Among the patients with complications, 96.9% were disease-related, and 50.8% were treatment-related complications. In older age, high proteinuria level, a low estimated glomerular filtration rate (eGFR) level at diagnosis, and female gender were significant risk factors for complication development (P = 0.000, P = 0.006, P = 0.04, and P = 0.07, respectively). Chronic kidney disease (CKD) developed in 7% of patients and 2.9% of patients had end-stage renal disease (ESRD). Additionally, three of 12 patients with progressive ESRD underwent transplantation. Also the incidence of ESRD was significantly higher in the patients with complications than in those without complications (P < 0.05). Conclusion The present findings suggest that careful monitoring of patients with childhood INS at risk for complications and implementation of personalized treatment programs can improve long-term outcomes, especially in patients that progress to ESRD and are followed-up with dialysis or transplantation as targeted therapy.

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Section: Discussionsupporting

confidence: 79%

Complications Related to Childhood Idiopathic Nephrotic Syndrome, Its Treatment and the Associated Risks in Patients

Karakaya,

Güngör,

Kargın Çakıcı

et al. 2023

Cureus

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“…However, the ESRD rate was only 2.9% in the group without disease or drug-related complications. This gure is higher than those reported by previous studies which reported a CKD prevalence of 3%-10% and an ESRD prevalence of 3.6% during a mean follow-up duration of 7.70 ± 3.81 years [48,49]. This supports the conclusion that the frequency of ESRD was higher in patients with complications compared with the literature.…”

Section: Discussionsupporting

confidence: 66%

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

Karakaya

Güngör

Çakıcı

et al. 2023

Preprint

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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.

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“…[ 1 ] The annual incidence rate of childhood nephrotic syndrome is 2–7 cases per 100,000 children aged <16 years (both internationally and locally). [ 2 ] Nephrotic syndrome has many aetiologies, including primary causes (or idiopathic nephrotic syndrome [INS]) such as minimal change disease (MCD), focal segmental glomerulosclerosis and membranous glomerulonephritis, and secondary causes such as systemic lupus erythematosus.…”

Section: Introductionmentioning

confidence: 99%

Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective

Nizam¹,

Othman²,

Ilias³

2021

Singapore Medical Journal

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Introduction: The study was performed to measure psychological problems in children with idiopathic nephrotic syndrome (INS) while on steroid therapy as compared to healthy children. Methods: It was a prospective cohort study conducted in a paediatric clinic of a tertiary hospital. Parents of participants, both in the INS group and the control group comprising children without chronic illness, were asked to complete questionnaires using the Child Behavioral Checklist (CBCL). CBCL measures a range of age-specific emotional and psychological problems including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test. Results: A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between INS group children and control group children, specifically in the withdrawal, somatic, anxious, and aggressiveness sub-domains. Similar findings were demonstrated in a correlation between total psychological problems with the dosage of corticosteroid. Within the INS children, steroid dose and Cushingoid features were found to have a significant positive association with internalising psychological problems. Conclusion: Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores compared to healthy children.

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Timing and predictive factors of developing chronic kidney disease in childhood-onset idiopathic nephrotic syndrome: an Asian experience

Cited by 3 publications

References 21 publications

Complications Related to Childhood Idiopathic Nephrotic Syndrome, Its Treatment and the Associated Risks in Patients

Complications Related to Childhood Idiopathic Nephrotic Syndrome, Its Treatment and the Associated Risks in Patients

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

Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective

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