Spot Urine Protein: Creatinine Ratio as Risk Factor in Relapsing Nephrotic Syndrome

Background: Nephrotic Syndrome is a common childhood illness. Major problem with this disease is frequent relapse. So, it is important to identify the children at risk for relapses to treat and further follow up. Aim &Objective: Aim of present study was to determine Spot PCR is a strong indicator of relapse in Nephrotic Syndrome. The primary objective of study was to determine the correlation between acute phase Spot PCR and subsequent relapses in Nephrotic Syndrome. Material and Method of study: Sixty two Nephrotic Syndrome children were included in this prospective cohort study at ICH&RC Madurai Medical College & Hospital. Spot PCR was estimated at the acute phase of disease before starting steroid therapy. They were followed up for six months from the time of remission to determine the further relapse. Results: A total of sixty two children were enrolled of whom two were excluded. Among the cases excluded, one children had steroid resistant Nephrotic Syndrome, one child was lost to follow up. Among, 60 included children, 20 cases had their first episodes and 40 cases were infrequent relapsers. In our study Spot PCR level for Relapsers 20.97±10.44 mg/mg and for non -relapsers 14.94±8.74 mg/mg. High level of Spot PCR at acute phase of Nephrotic syndrome was a risk factor for relapse with Adjusted OR 1.09, significance 0.014 and 95%CI of OR 1.02,1.17. Conclusion: Proteinuria has prognostic significance for renal diseases. Severity of Renal involvement in Nephrotic syndrome was determined by level of proteinuria. Significantly elevated level of Spot PCR at acute phase of disease is a predictor of further relapses in Nephrotic syndrome.