Demographic Charecterstics of Children with First Attack Idiopathic Nephrotic Syndrome with Relapse- A Hospital-Based Observational Study

Background: Idiopathic nephrotic syndrome (INS) is a common childhood illness with or without relapses. So, the objectives of this study is to find out such children who are prone to develop frequent relapse and the demographic characteristics responsible for relapse. 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 6 weeks, followed by 40 mg/m2 every alternate day for another 6 weeks and were analyzed and followed up for a minimum period of six months to identify the risk factors related to relapses.

Results: Among them, 50 (66.7%) were males, 25 (33.3%) were females, with a male: female ratio of 2:1. 10 (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 1 week. Early age at onset, male gender, rural inhabitants, low socioeconomic status and atopy, though statistically not significant, are strongly associated with frequent relapses.

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.