Clinical Profile and Outcome of Steroid Resistant Nephrotic Syndrome in Children: An Eastern Indian Single Centre Study

Background: Steroid resistant Nephrotic syndrome (SRNS) is a therapeutic challenge for pediatricians and pediatric nephrologists worldwide. Currently, numerous immunosuppressive agents are used with variable efficacy. Materials and Methods: This prospective study was conducted from February 2008 to October 2013 in the department of Pediatrics at SVPPGIP and SCB Medical College, Cuttack, India in 44 children with SRNS aged 6 months-14 years. The demographic, clinical, laboratory data at the time of presentation, response to various therapies and follow up data of 12 months was noted. Data was compiled and analyzed with Microsoft Excel software. Results: Out of 44 SRNS children, Male: female ratio was 1.2:1. Nineteen (43.18%) children had Minimal Change Disease (MCD), 13 (29.54%) had Focal Segmental Glomerulosclerosis (FSGS), 7 (15.9%) cases had IgA Nephropathy (IgAN) and 3 cases had IgM Nephropathy (IgMN). Most (n=29; 65.9%) of the children responded to Cyclosporin A (CyA). Thirty seven (84.1%) cases were late steroid responders. During follow up, 39 (88.64%) children were in complete remission. There were no major adverse effects except Cushingoid features and Hirsutism. Conclusions: In our study, MCD was most common histological subtype of SRNS and majority of the children responded to Cyclosporin A.