Idiopathic nephrotic syndrome has a high risk for relapse in ethnic children: study

Nephrotic Syndrome is a condition wherein excess albumin is released from the body via urine, indicating damage to one or both the kidneys.

The kidneys have many folds of minute blood vessels and each of these blood vessels is called a glomerulus. The function of glomeruli is to filter substances from the blood into the urine. In Nephrotic syndrome, these glomeruli are not able to function normally. Although nephrotic syndrome can affect people of any age, it's usually first diagnosed in children. When the exact cause for this abnormality cannot be pinpointed, it is referred to as Idiopathic Nephrotic Syndrome.

A group of researchers from the University of Amsterdam, Netherlands conducted a study to gauge the overall pooled weighted incidence and risk for relapse of idiopathic nephrotic syndrome in children.

The researchers selected a total of 73 studies that reported incidence (per 100 000 children per year) and/or risk for relapse (the proportion of patients who experience more than 1 relapse) of idiopathic nephrotic syndrome in children (age: less than 18 years). They finalized 27 incidence and 54 relapse studies. Following which a quality assessment was conducted, wherein data was extracted related to study design, localization, sample size, and patient demographics, characteristics, incidence, and risk for relapse.

The findings of the study are as follows:

Ø The overall pooled weighted estimate of the incidence was 2.92 per 100 000 children per year (95% PI: 0.00–6.51).

Ø In non-western countries, the incidences were higher (P < .001).

Ø The incidence was slightly lower in white children.

Ø The overall pooled weighted estimate of the risk for relapse was 71.9% (95% PI: 38.8–95.5).

Ø Incidence was constant between the years 1945 and 2011(P = .39), while the risk for relapse decreased significantly (P = .024), from 87.4% to 66.2%.

The researchers concluded that though idiopathic nephrotic syndrome shows decreased incidence with ethnic variation, there is a high risk for relapse. Despite the use of corticosteroids to bring down the risk for relapse, it remains unacceptably high, thus undermining the need for alternative treatment modalities.

Reference:

A study titled, "Incidence and Relapse of Idiopathic Nephrotic Syndrome: A meta-analysis" by Veltkamp F et. al published in the Official Journal of the American Academics of Paediatrics.

DOI: https://doi.org/10.1542/peds.2020-029249