当前位置: X-MOL 学术Pediatr. Nephrol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Long-term complications in patients with childhood-onset nephrotic syndrome
Pediatric Nephrology ( IF 3 ) Pub Date : 2022-08-09 , DOI: 10.1007/s00467-022-05693-0
Joyita Bharati 1 , Karalanglin Tiewsoh 2 , Lesa Dawman 2 , Tarvinder Singh 3 , Ujjwal Gorsi 3 , Arun Prabhahar Rajarajen 1 , Aakanksha Sharma 1 , Rahul Chanchlani 4 , Raja Ramachandran 1 , Harbir Singh Kohli 1
Affiliation  

Background

Reports on long-term complications of childhood-onset nephrotic syndrome (NS), such as obesity, osteoporosis, growth failure, and hypertension, are mostly from developed countries not representing South Asian ethnicities. Furthermore, data on cardiovascular health among patients with childhood-onset NS are limited.

Methods

This was an observational study involving patients attending a tertiary care center. Patients aged 15 years and older were examined for long-term complications and remission of NS at their visit in December 2021. Childhood-onset NS meant onset of NS before 10 years of age. Long-term complications included obesity, growth failure, low bone mineral density (BMD) Z score, hypertension, and increased carotid intima-media thickness (cIMT). Long-term remission was defined as no relapse for the last \(\ge\) 3 consecutive years without immunosuppressive medication to maintain remission.

Results

Of 101 patients studied (~ 80% with frequent relapsing (FR)/steroid-dependent (SD) NS), the mean age was 17.6 (± 2.4) years at the time of study. Long-term complications were noted in 89.1% of patients which included one or more of the following: obesity (22.7%), growth failure (31.7%), low BMD Z score (53.5%), hypertension (31.7%), and high cIMT (50.5%). Thirty-nine patients (38.6%) were in long-term remission at the time of the study. Growth failure and low BMD Z scores were less frequent in patients with long-term remission compared to those without long-term remission.

Conclusions

In patients with childhood-onset NS (predominantly FR/SDNS) who were studied at \(\ge\) 15 years of age, ~ 90% had long-term complications which included high cIMT in 50%. Only ~ 40% were in long-term remission.

Graphical abstract



中文翻译:

儿童期肾病综合征患者的长期并发症

背景

肥胖、骨质疏松、生长障碍和高血压等儿童期肾病综合征 (NS) 长期并发症的报告大多来自发达国家,并不代表南亚种族。此外,儿童期发病的 NS 患者的心血管健康数据有限。

方法

这是一项观察性研究,涉及在三级医疗中心就诊的患者。15 岁及以上的患者在 2021 年 12 月就诊时接受了 NS 的长期并发症和缓解情况的检查。儿童期发病的 NS 是指 NS 在 10 岁之前发病。长期并发症包括肥胖、生长障碍、低骨密度 (BMD) Z评分、高血压和颈动脉内膜中层厚度增加 (cIMT)。长期缓解定义为最近\(\ge\)连续 3 年没有复发,没有免疫抑制药物维持缓解。

结果

在研究的 101 名患者中(约 80% 患有频繁复发 (FR)/类固醇依赖性 (SD) NS),研究时的平均年龄为 17.6 (± 2.4) 岁。89.1% 的患者出现长期并发症,包括以下一项或多项:肥胖 (22.7%)、生长障碍 (31.7%)、低 BMD Z 评分 (53.5%)、高血压 (31.7%)高cIMT (50.5%)。研究期间,39 名患者 (38.6%) 处于长期缓解期。与没有长期缓解的患者相比,长期缓解患者的生长障碍和低 BMD Z评分较少见。

结论

在\(\ge\) 15 岁的儿童期发病的 NS(主要是 FR/SDNS)患者中,约 90% 有长期并发症,其中 50% 有高 cIMT。只有约 40% 的人处于长期缓解期。

图形概要

更新日期:2022-08-09
down
wechat
bug