Clinical,pathologic and prognostic analysis in children with steroid-resistant nephritic syndrome / 重庆医学

ABSTRACT

Objective To study the features of clinic ,pathology and prognosis in children with steroid-resistant nephritic syn-drome(SRNS) .Methods Children with SRNS hospitalized in Division of Nephrology and Immunology in our hospital from January 2003 to December 2012 were analyzed retrospectively in clinic ,pathology and prognosis .Results 162 patients were investigated , which accounted for 10 .8% of children with Primary nephritic syndrome(PNS) ,and the mean age of onset was 6 .9 ± 3 .8 years old . Renal biopsy was performed in 132 patients ,60 of them showed mesangial proliferative glomerulonephritis(MsPGN) ,30 showed fo-cal segmental glomerulosclerosis(FSGS) ,19 showed minimal change disease(MCD) ,8 showed membranoproliferative glomerulone-phritis(MPGN) ,5 showed membranous nephropathy(MN) ,1 showed proliferative sclerosis glomerulonephritis(PSGN) .Patients with non-minimal change disease(non-MCD)had a significant prevalence of hematuria .The distribution of pathologic type among age groups and clinical classification was significantly different ,respectively(P<0 .05) .(2)132 patients were followed up ,58 of them were in complete remission ,26 were in partial remission ,15 were not in remission ,8 were dead ,and the mean time for com-plete remission was 15 months(3-84 .Prognosis correlated with pathologic type(P<0 .01) .Conclusion (1)There is a preponder-ance of non-MCD in children with SRNS ,and MsPGN and FSGS is the major pathologic type .Hematuria is a predictor of glucocor-ticoid resistance .(2)Children with SRNS have a long time proteinuria and poor prognosis .FSGS has a poor prognosis ,when com-pared with MsPGN .