Triggers, Duration of Therapy and Sedimentation Rate in Children with Nephrotic Syndrome

Aim: Triggers, duration of daily corticosteroid therapy and the role of Erythrocyte Sedimentation Rate (ESR) in children with Idiopathic Steroid Sensitive-Nephrotic Syndrome (SSNS) were evaluated. Methods: 40 episodes (9 initial episodes and 31 relapses) of idiopathic SSNS in 9 children were evaluated (2 had FSGS, 5 minimal change diseases). Data are presented as average +/- standard deviation. Different subgroups were compared with student's t-test and equality of variance tested with F-test. Results: All of the 9 initial episodes and only 58.1 % of relapses were triggered by acute, mostly afebrile respiratory tract infections. Duration of daily corticosteroid therapy was shorter in patients with Steroid-Dependent Nephrotic Syndrome (SDNS) compared to other patients (14.5 +/- 7.6 vs. 24.7 +/- 6.8 days, p=0.071) and shorter in small children with Body Surface Area (BSA) < 1 m2 compared to children with BSA > 1 m2 (14.8 +/- 9.8 vs. 26.7 +/- 18.9 days, p = 0.058) but the difference did not reach statistical significance. Average ESR was 71,6 +/- 30,5 mm/h in initial episodes compared to 20,5 +/- 23,8 mm/h in relapses (p = 0.000058). The correlation coefficient between time to achieve remission and ESR was 0.09. Conclusion: Children with initial episodes of SSNS had higher proportion of triggers as well as higher ESR compared to relapses. There was no correlation between time to achieve remission with daily corticosteroid therapy and ESR or between histology result of renal biopsy and clinical course of SSNS.