Time for Initial Response to Steroids Is a Major Prognostic Factor in Idiopathic Nephrotic Syndrome

Marina Vivarelli, Eleonora Moscaritolo, Aggelos Tsalkidis, Laura Massella, Francesco Emma

Research output: Contribution to journalArticle

Abstract

Objective: To identify early prognostic factors for idiopathic nephrotic syndrome (INS) in childhood. Study design: A retrospective analysis of 103 patients with INS at onset, all treated in a single center with the same induction protocol, was conducted. Minimum length of follow-up was 2 years; median length of follow-up was 43 months. Survival data were assessed with Cox-Mantel analysis. Predictive values were estimated with receiver operating characteristic curves. Results: The median time of response to steroid therapy was 7 days. A significant association was found between the interval from onset of steroid therapy to remission and the risk of relapsing within 3 months after steroid therapy discontinuation (P <.0001). A similar association was found between the time to achieve remission and the risk of developing frequent relapsing or steroid-dependent nephrotic syndrome (P <.0001), the prescription of maintenance steroid therapy (P <.003), and the prescription of all other non-steroid drugs (P <.0001) during follow-up. Patients with non-relapsing and infrequent relapsing nephrotic syndrome had a median time to achieve remission 7 days. Conclusion: The interval from onset of steroid therapy to remission is an accurate early prognostic factor in INS.

Original languageEnglish
Pages (from-to)965-971
Number of pages7
JournalJournal of Pediatrics
Volume156
Issue number6
DOIs
Publication statusPublished - Jun 2010

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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