Evaluation of Response to Treatment in Children with Nephrotic Syndrome over a 10-Year Period: A Retrospective Study

Authors

1 Pediatric Nephrologist, Children & Adolescent Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran.

2 Medical Student, School of Medicine, Beheshti University of Medical Sciences, Tehran, Iran.

3 Medical Practitioner, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

4 Pediatric Resident, Department of Pediatrics, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

Abstract

Background
Nephrotic syndrome (NS), defined as massive loss of urinary protein results in a triad of hypoalbuminemia, hyperlipidemia and edema. We aimed to determine the frequency of clinical symptoms, laboratory findings and treatment response in children with Nephrotic Syndrome.
Materials and Methods: We conducted a longitudinal retrospective study from 2009 to 2019 at a single regional pediatric center, Zahedan, Iran, on 206 children (up to 14 years) with NS that were selected from all clinical records files. Parameters extracted included age, sex, presenting symptoms, blood pressure. Laboratory information included complete blood count, urine analysis, 24-hour urinary protein excretion, creatinine clearance, serum electrolytes, serum urea and creatinine levels, total protein and albumin, triglyceride and cholesterol, acute phase reactant, treatment and outcome. All the data extracted were recorded in pre-prepared forms.
Results: A total of 107 men (52%) and 99 women (49%) participated in the study. Edema was most commonly found in 197 (95.6%), respiratory distress in 2 (0.9%), abdominal pain in 45 (21.8%), nausea and vomiting in 28 (13.5%), and gross hematuria in 6 (2.9%). Leukopenia was seen in 0.5% followed by 42.4% of normal white blood cells (WBCs) and 57.1% leukocytosis. 74.4% of all patients had anemia in their laboratory tests in spite of thrombocytopenia only seen in 1.7%. 49% had pyuria and hematuria was seen in 41%. The mean level of serum albumin was 2.5 g/l, cholesterol was 381 mg/dl, triglyceride was 287 mg/dl and the mean level of 24-hour urinary protein excretion was 2084 mg/dl.
Conclusion
The most common clinical symptom in nephrotic syndrome was edema followed by nausea and vomiting and abdominal pain.

Keywords