Risk of idiopathic nephrotic syndrome among children with asthma: a nationwide, population-based cohort study

IntroductionIdiopathic nephrotic syndrome (INS) is the most common glomerulopathy that results in childhood chronic kidney disease in China, but the relationships between different clinical phenotypes and immunological genetic variants observed in patients with INS are ambiguous and have not been well studied. A cohort study combined with whole exome sequencing might further identify the effects of immunological genetic variants on clinical phenotypes and treatment outcomes.Methods and analysisWe describe a 3 year prospective observational single-centre cohort study to be conducted in the Children’s Hospital of Chongqing Medical University in China. This study will recruit and investigate 336 patients with childhood-onset INS presenting with different clinical phenotypes. Whole exome sequencing will be conducted when patients progress to a confirmed clinical phenotype during follow-up. Relevant clinical and epidemiological data, as well as conventional specimens, will be collected at study entry and 1 month, 3 months, 6 months, 1 year, 2 years and 3 years after disease onset. After this cohort is generated, the immunological genetic variants of steroid-sensitive nephrotic syndrome without frequent relapse, steroid-resistant nephrotic syndrome and steroid-dependent/frequent relapse nephrotic syndrome will be evaluated.Ethics and disseminationThe study protocol is approved by Ethics Committee of Children’s Hospital of Chongqing Medical University (reference number 2018–140). The results will be disseminated through peer-reviewed journals and conference presentations.Trial registration numberChiCTR1800019795

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Clinical Features of Idiopathic Nephrotic Syndrome and Factors Associated with its Relapse in Children: A Population-Based Study

Journal of Comprehensive Pediatrics ◽

10.5812/compreped.108024 ◽

2020 ◽

Vol 11 (4) ◽

Author(s):

Abolhassan Seyezadeh ◽

Mohamad Reza Tohidi ◽

Somaye Sheikhi ◽

Mohammad Saleh Seyedzadeh ◽

Sara Hookari

Keyword(s):

Nephrotic Syndrome ◽

Recurrence Rate ◽

Clinical Features ◽

Idiopathic Nephrotic Syndrome ◽

Population Based ◽

Steroid Resistance ◽

Filtration Barrier ◽

The Mean ◽

First Recurrence

Background: Idiopathic Nephrotic Syndrome (INS), which is caused by a defect in the glomerular filtration barrier, is the most common chronic glomerular disease in children. Objectives: The present study aimed to assess the clinical features of INS and some recurrence-related factors in children. Methods: This population-based, cross-sectional study was conducted on 302 children with INS referring to the Pediatric Nephrology Clinic of Imam Reza Hospital of Kermanshah city, Iran, during 1998-2018. Results: The mean age (SD) at the time of diagnosis and the follow-up duration were 4.87 (2.89) years and 49.83 (37.52) months, respectively. The numbers of boys and girls were 185 (61.9%) and 114 (38.1%), respectively. The mean number (SD) of recurrences, annual recurrence rate during the follow-up, and the time to the first recurrence after responding to treatment were 1.71 (1.91), 0.48 (0.77), and 10.15 (10.63) months, respectively. The most common type of INS was steroid-dependent/frequent relapse, with a frequency of 151 (50.5%). Furthermore, 33 (11.0%) and 266 (89.0%) patients were resistant and respondent to treatment, respectively. There was a statistically significant relationship between age at the time of diagnosis and the type of INS (P = 0.007). Conclusions: This study revealed a statistically significant association between higher age and steroid resistance. However, in steroid responders, there was no relationship between gender, age at the time of diagnosis, and the time to the first recurrence, and the recurrence rate.

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Premature birth carries a higher risk of nephrotic syndrome: a cohort study

Scientific Reports ◽

10.1038/s41598-021-00164-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chih-Chia Chen ◽

Tsung Yu ◽

Hsin-Hsu Chou ◽

Yuan-Yow Chiou ◽

Pao-Lin Kuo

Keyword(s):

Nephrotic Syndrome ◽

Cohort Study ◽

Gestational Age ◽

Preterm Births ◽

Subsequent Development ◽

Maternal Diabetes ◽

Population Based ◽

Term Infants ◽

Serious Infections ◽

Nephrotic Range Proteinuria

AbstractThe pathogenesis of nephrotic syndrome is unclear. We conducted a nationwide population-based cohort study to examine the associations between preterm births and subsequent development of NS. NS was defined as ≥ 3 records with ICD-9-CM codes for NS in hospital admission or outpatient clinic visits. To avoid secondary nephrotic syndrome or nephritis with nephrotic range proteinuria, especially IgA nephropathy, we excluded patients with associated codes. A total of 78,651 preterm infants (gestational age < 37 weeks) and 786,510 matched term infants born between 2004 and 2009 were enrolled and followed until 2016. In the unadjusted models, preterm births, maternal diabetes, and pregnancy induced hypertension were associated with subsequent NS. After adjustment, preterm births remained significantly associated with NS (p = 0.001). The risk of NS increased as the gestational age decreased (p for trend < 0.001). Among the NS population, preterm births were not associated with more complications (Hypertension: p = 0.19; Serious infections: p = 0.63, ESRD: p = 0.75) or a requirement for secondary immunosuppressants (p = 0.61). In conclusion, preterm births were associated with subsequent NS, where the risk increased as the gestational age decreased. Our study provides valuable information for future pathogenesis studies.

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Incidence and Relapse Triggers of Childhood Idiopathic Nephrotic Syndrome between 2006 and 2016: A Population-Based Study in Fukushima, Japan

The Tohoku Journal of Experimental Medicine ◽

10.1620/tjem.253.125 ◽

2021 ◽

Vol 253 (2) ◽

pp. 125-134

Author(s):

Yohei Kume ◽

Yukihiko Kawasaki ◽

Kazuhide Suyama ◽

Ryo Maeda ◽

Yui Takahashi ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Idiopathic Nephrotic Syndrome ◽

Population Based ◽

Population Based Study

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Antibiotic use in children with asthma: cohort study in UK and Dutch primary care databases

BMJ Open ◽

10.1136/bmjopen-2018-022979 ◽

2018 ◽

Vol 8 (11) ◽

pp. e022979 ◽

Cited By ~ 3

Author(s):

Esmé J Baan ◽

Hettie M Janssens ◽

Tine Kerckaert ◽

Patrick J E Bindels ◽

Johan C de Jongste ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Antibiotic Use ◽

Population Based ◽

Health Improvement ◽

Antibiotic Overuse ◽

Asthmatic Children ◽

Antibiotic Drugs ◽

Children With Asthma ◽

Tract Infections

ObjectivesTo compare the rate, indications and type of antibiotic prescriptions in children with and without asthma.DesignA retrospective cohort study.SettingTwo population-based primary care databases: Integrated Primary Care Information database (IPCI; the Netherlands) and The Health Improvement Network (THIN; the UK).ParticipantsChildren aged 5–18 years were included from January 2000 to December 2014. A child was categorised as having asthma if there were ≥2 prescriptions of respiratory drugs in the year following a code for asthma. Children were labelled as non-asthmatic if no asthma code was recorded in the patient file.Main outcome measuresRate of antibiotic prescriptions, related indications and type of antibiotic drugs.ResultsThe cohorts in IPCI and THIN consisted of 946 143 and 7 241 271 person years (PY), respectively. In both cohorts, antibiotic use was significantly higher in asthmatic children (IPCI: 197vs126 users/1000 PY, THIN: 374vs250 users/1000 PY). In children with asthma, part of antibiotic prescriptions were for an asthma exacerbation only (IPCI: 14%, THIN: 4%) and prescriptions were more often due to lower respiratory tract infections then in non-asthmatic children (IPCI: 18%vs13%, THIN: 21%vs12%). Drug type and quality indicators depended more on age, gender and database than on asthma status.ConclusionsUse of antibiotics was higher in asthmatic children compared with non-asthmatic children. This was mostly due to diseases for which antibiotics are normally not indicated according to guidelines. Further awareness among physicians and patients is needed to minimise antibiotic overuse and limit antibiotic resistance.

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