ABSTRACT

Background

There is a paucity of data from India on ophthalmological complications in children on long-term oral corticosteroids for idiopathic nephrotic syndrome.

Methods

All children aged 4–18 years with idiopathic nephrotic syndrome who had received long-term oral steroids for >6 months and who attended the paediatric nephrology clinic between January 2019 and January 2021 were included. The majority of them (95/110) were being followed up in the paediatric nephrology clinic which was functioning from 2010. The children were screened for ophthalmological complications at 6-month intervals.

Results

Overall, 110 children with nephrotic syndrome were enrolled. Their median (IQR) age was 9.4 (7.0–12.8) years, and the median (range) duration of follow-up following onset of nephrotic syndrome was 5 years (1.0-16). The incidence of cataract was 18.1% (20 of 110 cases). Visual acuity was impaired in seven (35%) of the children with cataract. Children with cataract were younger as compared to those without cataract [Median (IQR) age at onset of nephrotic syndrome [2.5 (2.0–4.0) yrs vs 4 (2.1–6.0) yrs] (p=0.03)]. Children with cataract also had higher cumulative dose of prednisolone intake (mg/m²) [28,669 (21,329–33,500) vs 14,995 (10,492–19,687)] (p<0.01)] and greater cumulative duration of prednisolone intake [4.3 (3.1–5.2) vs 2.25 (1.3–3.7) yrs] (p<0.01). The incidence of raised IOP was 9.1% (10 of 110 cases).

Conclusions

The incidence of cataract and raised IOP was high. The risk factors for the development of cataract were age at onset of nephrotic syndrome, cumulative dose and cumulative duration of steroid intake.

中文翻译：

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接受长期口服皮质类固醇的肾病综合征患儿眼科并发症的发生率和预测危险因素：一项队列研究

摘要

背景

印度缺乏关于长期口服皮质类固醇治疗特发性肾病综合征的儿童眼科并发症的数据。

方法

纳入 2019 年 1 月至 2021 年 1 月期间接受长期口服类固醇治疗 > 6 个月并在儿科肾脏病诊所就诊的所有 4-18 岁特发性肾病综合征儿童。他们中的大多数 (95/110) 正在从 2010 年开始运作的儿科肾脏病诊所接受随访。每隔 6 个月对儿童进行一次眼科并发症筛查。

结果

总共招募了 110 名肾病综合征儿童。他们的中位 (IQR) 年龄为 9.4 (7.0-12.8) 岁，肾病综合征发病后的中位（范围）随访时间为 5 年 (1.0-16)。白内障的发病率为 18.1%（110 例中的​​ 20 例）。七名（35%）白内障儿童视力受损。与没有白内障的儿童相比，患有白内障的儿童更年轻[肾病综合征发病时的中位 (IQR) 年龄 [2.5 (2.0–4.0) 岁vs 4 (2.1–6.0) 岁] ( p = 0.03)]。白内障儿童的泼尼松龙累积摄入量也更高（mg/m ²）[28,669 (21,329–33,500) vs 14,995 (10,492–19,687)] ( p<0.01)] 和更长的泼尼松龙摄入累积持续时间 [4.3 (3.1–5.2) vs 2.25 (1.3–3.7) 年] ( p <0.01)。眼压升高的发生率为 9.1%（110 例中的​​ 10 例）。

结论

白内障和眼压升高的发生率很高。白内障发生的危险因素是肾病综合征发病年龄、类固醇摄入的累积剂量和累积持续时间。