Publication: Evaluation Of Treatment Outcomes And Prognostic Factors In Managing Children With Steroid Sensitive Nephrotic Syndrome In Malaysia
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Date
2025-05
Authors
Mohamad, Khairunnisa
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Abstract
Steroid sensitive nephrotic syndrome (ssns) in children generally has a positive prognosis, yet a subset experiences frequent relapses or steroid dependent nephrotic syndrome (fr/sdns), posing management challenges. Steroids, mainly prednisolone, are the first-line treatment, with steroid sparing agents (ssas) reserved for ongoing relapses, steroid toxicity, or persistent steroid dependency. Despite evolving treatment protocols, studies on ssns management outcomes in malaysian children remain limited. Therefore, this study aimed to assess treatment outcomes and identify prognostic factors influencing fr/sdns development and the need for ssa. This retrospective multicentre cohort study followed 216 children with ssns for a median of 3.4 years (range 1.0–15.0). Among them, 58.8% developed fr/sdns, 27.3% had infrequent relapses, and 13.9% achieved sustained remission. The initial steroid protocol, either short or prolonged, did not influence fr/sdns risk (p=0.619). However, fr/sdns patients experienced earlier first relapses (median: 4.2 months, range: 1.0-37.7) and a higher incidence of steroid-related adverse effects (50.4%). A relapse within six months of diagnosis was strongly associated with fr/sdns development (adjusted odds ratio [aor] 7.04, 95% ci 3.53-14.02).
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Evaluation Treatment Outcomes Prognostic Factors Managing