Clinical Review of Idiopathic Nephrotic Syndrome in Children

ABSTRACT

PURPOSE: We reviewed the clinical manifestations, responsiveness to treatment, and prognosis in children with nephrotic syndrome. METHODS: Medical records of 159 children with idiopathic nephrotic syndrome who were admitted to the pediatric department of Chonbuk National University Hospital from January 1979 to December 2000 were retrospectively reviewed. RESULTS: There were 32 females and 127 males. The most common age group was between 3 and 5 years of age among the 159 children with nephrotic syndrome. Generalized edema (75.5%), scrotal edema (20.1%), upper respiratory infection (19.5%), and ascites (28.3%) were frequently observed. After the initial steroid therapy, diuresis occurred within the first two weeks in 138 children, and proteinuria disappeared within the first two weeks in 105 children. Among 159 patients who received initial daily steroid therapy, 110 children were in complete remission, 29 children were in partial remission and 20 children were in poor response state. Hematuria, hypertension and elevated serum creatinine were more frequently observed in the partial and the poor response groups than in the complete remission group. Among 107 children who were followed up for more than one year, 78 children were in complete remission and 55 children were relapsed within the first one year after steroid therapy. Renal biopsy was undertaken in 76 children and 53 children had minimal change nephrotic syndrome. CONCLUSION: Our study showed that most children with idiopathic nephrotic syndrome have a good responsiveness to steroid therapy and even most children show frequent relapse during 1st year after remission, long term prognosis is excellent.