Relapse in Steroid-sensitive Nephrotic Syndrome

The objective of this study was to identify predictors of relapse and determine the predictive score for relapse in steroid-sensitive nephrotic syndrome. Ninety-nine children with nephrotic syndrome visiting the pediatric nephrology outpatient clinic of Soetomo Hospital from 1983 to 2001 were studied. There were 63 children with relapses (50 infrequent relapses, 13 frequent relapses) and 36 children without a relapse for at least 1 year after beginning steroid treatment, which served as a control group. The selected variables were grouped into non-renal factors (age, sex, nutritional status, infection) and renal factors (histopathologic findings, hypertension, hematuria, azotemia, hypocomplementemia, rapidity of early steroid response, number of relapses within the first 6 months, time-interval between early steroid response and first relapse). Using the discriminant analysis function test, it was found that the statistically significant predictors of relapse were the time-interval between early steroid response and the first relapse, number of relapses within the first 6 months, infection during the first relapse, hematuria and sex. A prediction score can be determined using 3, 5 or 6 parameters by including the rapidity of early steroid response.