Influencing factors and hormone resistance of 510 children with nephrotic syndrome
10.3969/j.issn.1006-2483.2024.04.019
- VernacularTitle:510例小儿肾病综合征激素耐药调查及其影响因素分析
- Author:
Jingshu LI
1
;
Ying WANG
1
Author Information
1. Department of Nephrology , Children's Hospital of Nanjing Medical University , Nanjing 210008 , Jiangsu , China
- Publication Type:Journal Article
- Keywords:
Nephrotic syndrome in children;
Clinical characteristics;
Hormone resistance
- From:
Journal of Public Health and Preventive Medicine
2024;35(4):79-82
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the hormone resistance and analyze its influencing factors in 510 children with nephrotic syndrome. Methods The clinical data of 510 children with primary nephrotic syndrome admitted to our hospital from January 2019 to August 2023 were retrospectively collected and analyzed. After 8 weeks of continuous treatment with conventional full-dose prednisone, urine protein detection was performed. Urine protein (+-+++) was listed as drug-resistant group, and urine protein (-) was regarded as control group. The general data, pathological types, and laboratory indicators were compared. Univariate analysis and Logistic regression analysis were used to screen the risk factors for hormone resistance in children with nephrotic syndrome. Results (1) After the end of 8 weeks of treatment, among the 510 children, there were 19 children with urine protein (+), 22 children with urine protein (++), 12 children with urinary protein (+++) and 457 children with urine protein (-). The total number of children with hormone resistance (drug-resistant group) was 53 cases (10.39%, 53/510), and the number of children with hormone sensitivity (control group) was 457 cases (89.61%, 457/510). (2) The proportions of children with onset age>8 years old and pathological type of focal stage glomerulosclerosis in drug-resistant group were higher than those in control group (P<0.05). (3) Univariate analysis showed that the urine protein, erythrocyte sedimentation rate, white blood cell count, CD8, serum creatinine, urea nitrogen, D-dimer and β2-microglobulin at disease onset were higher in drug-resistant group than those in control group (P<0.05) while the CD4 and 25-hydroxyvitamin at disease onset were lower than those in control group (P<0.05). (4) Multivariate analysis showed that high urine protein, erythrocyte sedimentation rate, CD8, serum creatinine, D-dimer and β2-microglobulin, and low 25-hydroxyvitamin and CD4 at disease onset were risk factors for hormone resistance in children with nephrotic syndrome (P<0.05). Conclusion For children with onset age later than 8 years old and high urine protein, erythrocyte sedimentation rate, CD8, serum creatinine, D-dimer and β2-microglobulin and low 25-hydroxyvitamin and CD4 at disease onset, it is necessary to take targeted anticoagulation, immune regulation and other treatments as soon as possible in order to achieve the best efficacy and improve the prognosis.
