Long-term outcome of biopsy-proven minimal-change nephrotic syndrome in Chinese children

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• 作者：Vickie Wai-Ki Kwong ; Bonnie Ching-Ha Kwan ; Kai-Ming Chow ; Chi-Bon Leung ; Philip Kam-Tao Li ; Cheuk-Chun Szeto ; ^{ccszeto@cuhk.edu.hk}
• 关键词：glomerulonephritis ; glucocorticoid ; nephrotic syndrome
• 刊名：Hong Kong Journal of Nephrology
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：15
• 期：1
• 页码：22-27
• 全文大小：339 K

文摘

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Summary

Background

Previous studies have shown that up to 40 % of childhood-onset minimal-change nephropathy (MCN) cases persist after puberty. However, data are scarce concerning the long-term renal prognosis and prevalence of treatment-related complications of this group of patients after they become adults.

Materials and methods

The clinical records of 55 consecutive pediatric patients with biopsy-proven MCN treated in our hospital from 1984 to 2004 were reviewed to evaluate the disease pattern, treatment regimen, and the development of treatment-related complications.

Results

Of the 55 patients treated, 35 were followed after age 18 years; 13 (37 % ) had relapses during adulthood. Treatment-related complications were observed in 20 patients (57 % ), including being overweight (23 % ), impaired fasting glucose (14 % ), infertility (14 % ), persistent low grade proteinuria (11 % ), fracture (9 % ), and hypertension (9 % ). All patients had normal renal function when last assessed.

Conclusion

A substantial proportion of patients with childhood-onset MCN continued to have relapse after they became adults. Although almost all patients have normal renal function, prolonged use of steroid and immunosuppressive agents results in a considerable risk of treatment-related complications. Life-long follow-up seems advisable for this group of patients, not only for detecting relapses, but also to allow timely diagnosis of treatment-related complications.