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Long-term complications in patients with childhood-onset nephrotic syndrome

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Abstract 

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.

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Authors and Affiliations

  1. Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Joyita Bharati, Arun Prabhahar Rajarajen, Aakanksha Sharma, Raja Ramachandran & Harbir Singh Kohli

  2. Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Karalanglin Tiewsoh & Lesa Dawman

  3. Department of Radiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Tarvinder Singh & Ujjwal Gorsi

  4. Division of Nephrology, Department of Pediatrics, McMaster Children’s Hospital, Hamilton, ON, Canada

    Rahul Chanchlani

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  1. Joyita Bharati
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Bharati, J., Tiewsoh, K., Dawman, L. et al. Long-term complications in patients with childhood-onset nephrotic syndrome. Pediatr Nephrol 38, 1107–1113 (2023). https://doi.org/10.1007/s00467-022-05693-0

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  • DOI: https://doi.org/10.1007/s00467-022-05693-0

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