Predictors of late remission in children with Nephrotic syndrome: A retrospective study Late remission in nephrotic syndrome
Journal of Pediatric Nephrology,
Vol. 13 No. 1 (2025),
12 May 2026
https://doi.org/10.22037/jpn.v13i1.49653
Abstract
Abstract:
Introduction:
Nephrotic syndrome is a disease requiring long duration of steroids as treatment. In this study we are analysing various factors, in children with this condition, which would predict delayed remission, hence requiring longer courses of steroids.
Methods:
This is a retrospective study, in children under 18 years, with nephrotic syndrome. Two hundred and three admissions were analysed. Age, course of nephrotic syndrome, presence of hypertension, cholesterol levels >400mg/dl, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, hyponatraemia and hypoalbuminemia were considered. Correlation of these parameters to delay in achieving remission (> 7 days) were done, followed by multinomial logistic regression. The score formulated from the resulting coefficients, was then tested on 63 separate cases using Receiver Operator Curve (ROC), and Area Under Receiver Operator Curve (AUROC) .
Results:
Significant spearman correlation (rho) were seen with - presence of hypertension (0.347), course of nephrotic syndrome being frequently relapsing or steroid resistant (0.319) , neutrophil to lymphocyte ratio >1.5 (0.312), cholesterol levels > 400mg/dl (0.201) and age > 10 years (0.201.
The multinomial logistic regression model showed coefficients of 2.81, 2.81, 1.98, 1.198, 1.063 for presence of hypertension, course of nephrotic syndrome, cholesterol level, Neutrophil to lymphocyte ratio and age, respectively.
A score of more than or equal to 4 predicted delayed remission, with a sensitivity and specificity of 85.6% and 83.7%. The AUROC of this score on a separate group of 63 children showed to be 0.835
Conclusion:
This score helps us to predict the cases of nephrotic syndrome, where delayed remissions occur, requiring prolonged courses of steroids, and hence leading to the ill effects of steroids.
- Steroid
- Nephrotic syndrome
- Edema
- albuminuria
- Relapse
How to Cite
References
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