Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Pediatr Nephrol. 2023 Apr;38(4):1107-1113. doi: 10.1007/s00467-022-05693-0. Epub 2022 Aug 9.
Reports on long-term complications of childhood-onset nephrotic syndrome (NS), such as obesity, osteoporosis, growth failure, and hypertension, are mostly from developed countries not representing South Asian ethnicities. Furthermore, data on cardiovascular health among patients with childhood-onset NS are limited.
This was an observational study involving patients attending a tertiary care center. Patients aged 15 years and older were examined for long-term complications and remission of NS at their visit in December 2021. Childhood-onset NS meant onset of NS before 10 years of age. Long-term complications included obesity, growth failure, low bone mineral density (BMD) Z score, hypertension, and increased carotid intima-media thickness (cIMT). Long-term remission was defined as no relapse for the last [Formula: see text] 3 consecutive years without immunosuppressive medication to maintain remission.
Of 101 patients studied (~ 80% with frequent relapsing (FR)/steroid-dependent (SD) NS), the mean age was 17.6 (± 2.4) years at the time of study. Long-term complications were noted in 89.1% of patients which included one or more of the following: obesity (22.7%), growth failure (31.7%), low BMD Z score (53.5%), hypertension (31.7%), and high cIMT (50.5%). Thirty-nine patients (38.6%) were in long-term remission at the time of the study. Growth failure and low BMD Z scores were less frequent in patients with long-term remission compared to those without long-term remission.
In patients with childhood-onset NS (predominantly FR/SDNS) who were studied at [Formula: see text] 15 years of age, ~ 90% had long-term complications which included high cIMT in 50%. Only ~ 40% were in long-term remission. A higher resolution version of the Graphical abstract is available as Supplementary information.
关于儿童期肾病综合征（NS）长期并发症的报告，如肥胖、骨质疏松、生长发育迟缓、高血压等，主要来自发达国家，不代表南亚种族。此外，关于儿童期 NS 患者心血管健康的数据也很有限。
这是一项观察性研究，涉及到一家三级保健中心的患者。2021 年 12 月，在患者就诊时，检查 15 岁及以上患者的 NS 长期并发症和缓解情况。儿童期 NS 是指发病年龄在 10 岁之前。长期并发症包括肥胖、生长发育迟缓、骨密度（BMD）Z 评分降低、高血压和颈动脉内膜中层厚度（cIMT）增加。长期缓解定义为过去[Formula: see text]3 年内无复发，且无免疫抑制药物维持缓解。
在 101 名研究患者中（约 80%为频繁复发（FR）/激素依赖性（SD）NS），研究时的平均年龄为 17.6（±2.4）岁。89.1%的患者存在长期并发症，包括以下一种或多种情况：肥胖（22.7%）、生长发育迟缓（31.7%）、BMD Z 评分降低（53.5%）、高血压（31.7%）和 cIMT 升高（50.5%）。39 名（38.6%）患者在研究时处于长期缓解状态。与无长期缓解的患者相比，长期缓解患者的生长发育迟缓及低 BMD Z 评分发生率较低。
在研究时年龄为[Formula: see text]15 岁的儿童期 NS（主要为 FR/SDNS）患者中，约 90%存在长期并发症，其中 50%存在高 cIMT。只有约 40%处于长期缓解状态。一幅高分辨率版本的图表摘要可在补充材料中查看。
