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Triggers of relapse in steroid-dependent and frequently relapsing nephrotic syndrome

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Abstract

An awareness of the triggers of relapse is critical for the control of steroid-dependent, frequently relapsing nephrotic syndrome (SDFRNS). We have investigated the triggers, usually described as ‘episodes’, to such relapses within a temporal context. Thirty-five patients with SDFRNS were analyzed retrospectively. A total of 442 relapses occurred in 2499 patient-months. The relapses were classified into two groups: those with episodes (E+) and those without episodes (E−). There were 135 E+ relapses and 296 E− relapses. The common cold was the most common episode (52%) of E+ relapse, followed by school events (18%). These E+ relapses occurred almost evenly throughout the 4 weeks between each follow-up visit. Conversely, 161 (55%) of the 296 E−z relapses occurred within the 3-day period preceding the patient’s appointment (relapse-related hospital visit, RRHV). McNemar’s test revealed that the concentration of relapses in this period was statistically significant (P < 0.00011). In addition, 15 out of 26 RRHV without additional therapy showed a spontaneous remission. From a chronological perspective, the common cold and school events as well as up-coming hospital visits may trigger relapses in SDFRNS patients.

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Authors and Affiliations

  1. Department of Pediatrics, Nihon University School of Medicine, 1-8-13 Chiyoda Ward, Kandasurugadai, Tokyo, 101-8309, Japan

    Shori Takahashi, Hitohiko Murakami, Satoshi Funaki & Kensuke Harada

  2. Division of Nephrology, Shizuoka Children’s Hospital, 860 Urushiyama, Shizuoka, Shizuoka, 420-0953, Japan

    Naohiro Wada

  3. Division of General Practice, Miyagi Children’s Hospital, 4-3-17 Ochiai, Aoba Ward, Sendai, Miyagi, 989-3126, Japan

    Tetsuji Inagaki

  4. Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan

    Michio Nagata

Authors
  1. Shori Takahashi
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  2. Naohiro Wada
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  3. Hitohiko Murakami
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  4. Satoshi Funaki
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  5. Tetsuji Inagaki
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  6. Kensuke Harada
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  7. Michio Nagata
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Correspondence to Shori Takahashi.

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Takahashi, S., Wada, N., Murakami, H. et al. Triggers of relapse in steroid-dependent and frequently relapsing nephrotic syndrome. Pediatr Nephrol 22, 232–236 (2007). https://doi.org/10.1007/s00467-006-0316-y

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  • DOI: https://doi.org/10.1007/s00467-006-0316-y

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