Clinicopathological Profile and Outcomes of Idiopathic Steroid-resistant Nephrotic Syndrome in Children: A Single Centre Experience Idiopathic Steroid-resistant Nephrotic Syndrome
Journal of Pediatric Nephrology,
Vol. 13 No. 1 (2025),
12 May 2026
https://doi.org/10.22037/jpn.v13i1.47919
Abstract
Background and Aim: Wide variations exist regarding different histopathological types
and treatment outcomes of idiopathic steroid-resistant nephrotic syndrome (iSRNS) in
children. This study has been conducted to evaluate clinicopathological profile and shortterm
outcomes of iSRNS in children and to analyze predictive factors for outcomes.
Methods: This cross-sectional observational study was conducted at a tertiary care hospital
in eastern India over a period of 18 months. Children with iSRNS aged 2–12 years, with
an available renal biopsy report, for whom treatment was started within six months, were
included. Data were collected at baseline and at 6 and 12-24 months.
Results: Of the 40 children with iSRNS (mean age: 1 year and 4 months; male: female
ratio: 1:1), 30% and 70% respectively had hematuria and hypertension at the onset of
nephrotic syndrome. Late SRNS was more common (55%) than initial SRNS (45%).
Before the development of late SRNS, the percentages of steroid-dependent, infrequent
relapsing and frequent relapsing nephrotic syndrome were 45.4%, 41% and 13.6%,
respectively. Focal segmental glomerulosclerosis (62.5%), minimal change nephrotic
syndrome (32.5%), and IgM nephropathy (5%) were the prevalent renal biopsy findings,
with no association to the clinical features or renal parameters. 75% of participants
received cyclosporine, and the rest received tacrolimus. The percentages of complete
remission, partial remission and no response at 6 months were 70%, 12.5% and 17.5%,
respectively; and at the end of 12–24 months they were 80%, 0% and 20%, respectively.
No predictive factors for outcome were found.
Conclusion: The present study explored the complex nature of iSRNS in children.
Development of SRNS cannot be predicted by any clinicopathological factors. Early age at
onset of NS and the presence of hypertension are likely indicators of subsequent development
of SRNS. A large percentage of iSRNS achieved complete remission with effective therapies
available in the era of modern medicine.
- Nephrotic Syndrome
- Idiopathic
- Steroid Resistant
- Children
How to Cite
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