Treatment Outcomes of Nephrotic Syndrome and Associated Factors in Children; at selected hospitals in northern Ethiopia, A Retrospective Study

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Date

2020-10

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Addis Abeba University

Abstract

Nephrotic syndrome is a glomerular disorder of childhood that is characterized by heavy proteinuria, hypoalbuminemia, hypercholesterolemia, and edema. Despite the availability of effective treatments, severe complication and relapse proteinuria which needs a prolonged corticosteroid treatment is the characteristic of the disease. The aim of this study was to evaluate the treatment outcome of nephrotic syndrome in children. A retrospective cross-sectional study was conducted among children diagnosed with nephrotic syndrome from 2010 to 2017 in Ayder Comprehensive Specialized hospital and Mekelle General Hospital. The data was entered and analyzed using SPSS version 22. Binary logistic regression statistical tests were performed. Pvalue <0.05 was considered statistically significant. A total of 159 nephrotic syndrome children were included from both Ayder Comprehensive Specialized hospital and Mekelle General Hospital. The mean age of participants at the initial diagnosis was 5.21 ± 2.66 years. A total of 150 (94.3%) of patients have shown response to initial steroid treatment. Remission was achieved in 80 (53%) of participants treated with steroids within 2 weeks of treatment. However, among patients who have remission in the first treatment episode 117(78%) of them have relapsed and only 33 (20.8%) patients remain in steroid sensitive nephrotic syndrome. 52 (32.7%) patients were categorized into infrequent relapse nephrotic syndrome while the remaining 65 (40.9%) patients have found to be steroid dependent/frequent relapse nephrotic syndrome. Early age at diagnosis, hematuria, acute kidney injury, infection, low serum albumin and remission time was found to significantly associate with poor prognosis. Despite good responses with steroid treatment have seen at initial treatment, the relapse rate was higher.

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Keywords

Nephrotic syndrome, Proteinuria, Prednisolone

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