Shamsun Nahar Shanta¹*, Afroza Begum², Syed S Haque³, Tahmina Jesmin³, Abdullah-Al Mamun⁴, Shanjida Sharmim⁴, Ashiqur Rahman Khan⁵ and Ashraful Islam⁶

¹Medical Officer, Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
²Professor and Chairman, Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
³Associate Professor, Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
⁴Assistant Professor, Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
⁵Associate Professor, Department of Medicine, Colonel Maleque Medical College, Manikganj, Bangladesh
⁶Assistant Professor, Department of Pediatrics, Comilla Medical College, Comilla, Bangladesh

*Corresponding Author: Shamsun Nahar Shanta, Medical Officer, Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Received: March 15, 2023; Published: November 28, 2023

Abstract

Background: NS is a disease of relapse. So, it is very important to find out such children who are prone to develop frequent relapses and the predictors responsible for deterioration. This retrospective study was conducted in the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, from September 2016 to August 2017.

Methods: A total of 75 patients of idiopathic nephrotic syndrome (INS) with the initial attack, aged 1–18 years, were enrolled in this study. All patients were treated with prednisolone 60 mg/m2/day, single morning dose for six weeks, followed by 40 mg/m2 every alternate day for another six weeks and were analyzed and followed up for a minimum period of six months to identify the risk factors related to relapses.

Result: Among them, 50 (66.7%) were males, 25 (33.3%) were females, with a male: female ratio of 2:1. Ten (13.3%) children had no relapse, 18 (24.0%) had infrequent relapse, and 40 (53.3%) had frequent relapse. Children responding between 2 and 4 weeks after the start of treatment had a higher chance of relapse (P = 0.002) than those who responded less than one week. Only urinary and respiratory tract infections are independent risk factors for subsequent relapse. Children with INS who have UTI at onset had a 1.55 times more chance for further relapse, and RTI caused a 1.42 times more chance for relapse. Patients with low serum albumin have 1.91 times more chance for relapse than those with high albumin, with insignificant association.

Conclusion: Young age at diagnosis of INS, male gender, low serum albumin, and infections were predictive risk factors of multiple relapses. So, physicians should be vigilant to monitor these patients closely and counsel the families of nephrotic children regarding the prediction of subsequent relapses and outcomes.

Keywords: Children; INS; Risk Factor

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Citation

Citation: Shamsun Nahar Shanta., et al. “The Risk Factor Associated with Relapse in Childhood Nephrotic Syndrome- A Hospital Based Retrospective Study".Acta Scientific Paediatrics 6.10 (2023): 49-53.

Copyright

Copyright: © 2023 Shamsun Nahar Shanta., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.