Long-term Follow-up Study of Children with Minimal Change Nephrotic Syndrome (MCNS).
- Author:
Jung Sue KIM
1
;
Hae Il CHEONG
;
Hyun Soon LEE
;
Yong CHOI
Author Information
1. Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Minimal change nephrotic syndrome;
Long-term follow-up
- MeSH:
Acute Kidney Injury;
Azotemia;
Child*;
Cyclophosphamide;
Cyclosporine;
Follow-Up Studies*;
Hematuria;
Humans;
Hypertension;
Incidence;
Levamisole;
Medical Records;
Methylprednisolone;
Nephrosis, Lipoid*;
Pathology;
Peritonitis;
Prednisolone;
Prognosis;
Proteinuria;
Recurrence;
Renal Insufficiency;
Retrospective Studies
- From:Journal of the Korean Pediatric Society
1998;41(12):1675-1684
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Most of childhood MCNS has a long disease course with frequent relapses. This study was designed to analyze the long-term clinical course of childhood MCNS, focusing at relapsing pattern, treatment response and complications. Mothods : The medical records of 137 children with biopsy-proven MCNS observed during 1976 ti 1996 were analyzed retrospectively. They were classified as initial responders (111 patients, 81%) and nonresponders (26 patients, 19%) according to the response to initial oral prednisolone (60mg/m2/d) for 4 weeks. The detailed clinical courses were obtained in 126 patients. RESULTS: The incidences of hematuria, hypertension and azotemia were more frequent in initial responders than nonresponders. During follow-up, the proportion of patients with sustained remission increased gradually with decreasing rate of relapse. At the last follow-up, 77 patients (61%) revealed sustained remission, 36 (29%) repeated relapses, 9 (7%) persistent proteinuria, 3 (2%) renal failure, and 1 (1%) death. The responses to secondary drugs such as first and second course of cyclophosphamide, cyclosporin, levamisole and methylprednisolone pulse were 80%, 85.7%, 70%, 75%, and 40%, respectively. Major complications were infections including peritonitis (29 patients) and acute renal failure (10) patients.CONCLUSION: Long-term prognosis of childhood MCNS is determined by clinical courses rather than renal pathology. Although majority of childhood MCNS reveal good long-term prognosis, patients did well, few patients do not so. Early detection and more aggressive therapy of such patients are very helpful.
