Treatment-Associated Side Effects in Patients with Steroid-Dependent Nephrotic Syndrome.

Abstract

Introduction:Nephrotic syndrome is one of the most extensively studied pediatric diseases for a nephrologist. Treatment for patients suffering from it has greatly improved the prognosis and reduced the mortality rate to 3% or less. Steroid medication is the first line, but non-steroid immunosuppressive drugs are useful in limiting steroid side effects and maintaining long-term remission. Objective: The aim of the study is to choose the best treatment for each patient in order to minimize long-term effects of corticosteroid therapy, taking into account the child's age, gender and other factors to optimize the quality of life. Materials and methods:Materials and methods: This is a retrospective study of pediatric patients older than one year and younger than 18 years of age diagnosed with idiopathic corticosteroid nephrotic syndrome. Study participants were treated in the Department of Pediatric Nephrology of "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania, between January 2013 and December 2020. Thirty-seven subjects with steroid-dependent nephrotic syndrome from a total of 125 patients diagnosed with nephrotic syndrome were included in the present study. All study participants underwent clinical examination and laboratory tests and were regularly monitored. Results and discussion: Long-term corticosteroid therapy can lead to unwanted complications such as hypertension, short stature, behavior disturbances, or osteopenia. To minimize certain side effects, a second line steroid-sparing agents can be used due to their ability to induce complete remission and maintain it in patients with steroid-dependent nephrotic syndrome. Conclusion: Our study describes the most frequent side effects encountered in the Department of Nephrology in patients with steroid-dependent nephrotic syndrome. The purpose was to emphasize that pediatric patients' quality of life depends on limiting long-term corticosteroid treatment and preventing adverse reactions or complications.