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Epidemiology of idiopathic nephrotic syndrome in children: endemic or epidemic?

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Abstract

Background

The etiology of idiopathic nephrotic syndrome (INS) remains partially unknown. Viral infections have been reported to be associated with INS onset and relapse. The aim of this study was to describe the epidemiology of a population-based cohort of children with INS and propose a spatiotemporal analysis.

Methods

All children aged 6 months to 15 years with INS onset between December 2007 and May 2010 and living in the Paris area were included in a prospective multicenter study. Demographic and clinical features at diagnosis and 2 years were collected.

Results

INS was diagnosed in 188 children, 93 % of whom were steroid sensitive. Annual incidence was 3.35/100,000 children. Standardized incidence ratio (SIR) was higher in one of the eight counties: Seine-Saint-Denis, with SIR 1.43 [95 % confidence interval (CI) 1.02–1.95]. A spatial cluster was further identified with higher SIR 1.36 (95 % CI 1.09–1.67). Temporal analysis within this overincidence area showed seasonal variation, with a peak during the winter period (p <0.01). In addition, partition of the Paris area into quintiles of the population showed that the average delay of occurrence, with regard to the first study case, followed a longitudinal progression (p <0.0001).

Conclusion

The clustering of cases, the seasonal variation within this particular area, and the progression over the Paris area altogether suggest that INS may occur on an epidemic mode.

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Authors and Affiliations

  1. Service de Néphrologie Pédiatrique, Hôpital Robert-Debré, APHP, Paris, France

    Claire Dossier & Georges Deschênes

  2. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France

    Nathanael Lapidus & Fabrice Carrat

  3. Department of Public Health, Hôpital Saint-Antoine, AP-HP, Paris, France

    Nathanael Lapidus & Fabrice Carrat

  4. Agence de la Biomédecine, Saint-Denis La Plaine, Paris, France

    Florian Bayer

  5. Service de Néphrologie Pédiatrique, Hospices Civiles de Lyon, Lyon, France

    Anne-Laure Sellier-Leclerc

  6. Service de Néphrologie Pédiatrique, Necker-Enfants-Malades, APHP, Paris, France

    Olivia Boyer

  7. Service de Pédiatrie, Hôpital Jean-Verdier, APHP, Bondy, France

    Loic de Pontual

  8. Service de Pédiatrie, Centre Hospitalier Sud Francilien, Corbeil-Essonne, France

    Adrien May

  9. Service de Pédiatrie, Centre Hospitalier de Versailles, Le Chesnay, France

    Sylvie Nathanson

  10. Service de Pédiatrie, Hôpital Saint-Camille Bry-sur-Marne, Le Chesnay, France

    Christine Orzechowski

  11. Unité de Recherche Clinique URC-Est, Université Paris 6, Paris, France

    Tabassome Simon

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  1. Claire Dossier
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  2. Nathanael Lapidus
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  12. Georges Deschênes
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Corresponding author

Correspondence to Claire Dossier.

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Conflict of interest

All authors declare no conflict of interest.

Ethical statement

The study was reviewed and accepted by the local ethic committee. A written informed consent was systematically signed by the parents and, when possible, by the patient (age >10 years).

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Dossier, C., Lapidus, N., Bayer, F. et al. Epidemiology of idiopathic nephrotic syndrome in children: endemic or epidemic?. Pediatr Nephrol 31, 2299–2308 (2016). https://doi.org/10.1007/s00467-016-3509-z

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  • DOI: https://doi.org/10.1007/s00467-016-3509-z

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