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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249

Abstract

HALTY, Margarita  and  CAGGIANI, Marina. Características evolutivas del síndrome nefrótico idiopático: Análisis de 70 casos. Arch. Pediatr. Urug. [online]. 2010, vol.81, n.3, pp.146-157. ISSN 1688-1249.

The aim of this study is to assess the follow-up profile of a population of children with Idiopathic Nephrotic Syndrome (INS) controlled for a minimum period of one year at the Nephrologic Service of the Pereira Rossell Hospital between 2000 and 2006. Clinical data, treatments, response to them, complications and situation at the end of follow-up were analysed retrospectively. 70 patients with a predominance of males in a ratio 1,8/1 were included. The average age at debut of the INS was 4,33 ± years, the follow-up was 5,9 ± 0,4 years. 80% of the patients were Steroid Sensitive (SS) and 20% Steroid Resistant (SR); in the first group, 73% were Steroid Dependent or Frequent Relapsers (SDFR). Response to cyclophosphamide was favourable in 62% of the patients SDFR and in 66% of the SR. Cyclosporine achieved a good response in 62.5% of the SDFR and in 75% of the SR. Renal biopsy was performed in 26 cases, 12 SDFR and 13 SR, predominating Focal Segmental Glomerulosclerosis in 67% and 69% respectively. At the end of the follow-up, 78% of the SDFR patients and 64% of the SR were in total remission; 68% of the first group and 44% of the second one were still receiving some immunosuppressive treatment. The Z score for height was carried out in 50 children and significant differences between height at the beginning of the disease, one year later and at the end of the follow-up were found. Infectious complications occurred in 25.7% of the patients, a patient developed chronic renal failure, no deaths were reported. Although a high percentage of remissions was achieved at the end of the follow-up, the course of the disease was prolonged, multiple immunosuppressive associations were required, infectious complications developed and significant impact on the growth was found.

Keywords : NEPHROTIC SYNDROME; IMMUNOSUPPRESIVE AGENTS -therapeutic use; GROWTH DISORDERS.

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