Risk Factor of Frequent Relapse in Pediatric Nephrotic Syndrome

Abstract

Background. Nephrotic syndrome (NS) is a kidney disease with high incidence. Although steroids therapy produces a good outcome with remission (80−95%), but the relapse rates are also high (60-90%). Relapsed NS patients experienced a long period treatment and become dependent on steroids, which might cause side effects such as short stature, overweight, osteoporosis, and cardiovascular disease. Some risk factors of relapse are age, late remission, first relapsed ≤6 months after remission, and short initial therapy. Study design. A cross-sectional study with retrospective data collection from medical record of patients with frequent and infrequent relapse nephrotic syndrome from January 2010 to December 2014. There were 90 patients which were divided in two groups, 45 frequent relapse and 45 infrequent relapse. Statistical analysis used bivariate and multivariate risk factor. Result. Boys:girls ratio was 4.6:1, with median age is 5 years and 5 month (65 months). From bivariate analysis, the first diagnosis ≤5 years (p<0.001) and time on remission ≤6 month (p<0.001) were the risk factor of frequent relapse. Multivariate analysis showed time on remission ≤6 month (OR 37.113, CI 95% (7.115−193.595)) more significant than the age at diagnosis ≤5 years (OR 8.0 CI 95% (2.402−26.645)) upon frequent relapse nephrotic syndrome. Conclusion. Time on remission ≤6 month and the age at diagnosis of NS ≤5 years were risk factor of frequent relapse in nephrotic syndrome patients.