Frequency of relapse among Nigerian children with steroid‑sensitive nephrotic syndrome

Abstract

Background: The clinical course of steroid‑sensitive nephrotic syndrome (SSNS) among Nigerian children has rarely been reported; this makes prognostication difficult.
Objectives: The objective was to determine the frequency of relapses including frequent relapses (FR) and steroid‑dependence (SD) in a cohort of Nigerian children with SSNS. A secondary objective was to identify clinical and demographic factors associated with relapse in these children.
Methods: Medical records of children with SSNS in a Tertiary Hospital in Nigeria were reviewed. Children with onset of nephrotic syndrome (NS) at age <1‑year, follow‑up period <12 months and secondary causes of NS were excluded. The relapse status of each child was determined in the 1st and 2nd year after diagnosis and the proportions with no relapse, FR and SD were calculated.
Results: Fifty children (68% males; median [range] age at onset of NS 4.8 [1.1–14.9] years) were followed‑up for 31.1 (12.1–79.8) months. In the 1st and 2nd year of follow‑up, 23 (46%) and 24 (70.6%) children experienced relapse, respectively. In the 1st‑year, 0% and 10% had FR and SD while in the 2nd year 2.9% and 11.8% had FR and SD, respectively. Age at onset of NS, gender, time to first remission, serum creatinine or presence of hypertension or microscopic hematuria was not associated with 1st or 2nd year relapse.
Conclusion: About half and two‑thirds of children with NS in our center experience relapse in the 1st and 2nd year of follow–up, respectively; much fewer proportions experienced FR and SD in these periods. None of the commonly reported demographic and clinical factors was associated with NS relapse.

Key words: Frequent relapses, prednisolone, steroid‑dependence