Comparison the Serum Level of Paraoxonase Activity in Frequent Relapse and Infrequent Relapse Patients with Nephrotic Syndrome

2021 ◽  
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Level ◽  
Paraoxonase Activity ◽  
Frequent Relapse

Short-Term Steroid Regimen for Adult Steroid-Sensitive Minimal Change Disease

2018 ◽  
Vol 49 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Takaya Ozeki ◽  
Takayuki Katsuno ◽  
Hiroki Hayashi ◽  
Sawako Kato ◽  
Yoshinari Yasuda ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Minimal Change Disease ◽  
Minimal Change ◽  
First Episode ◽  
Short Term ◽  
Short Term Treatment ◽  
Steroid Dose ◽  
Steroid Sensitive ◽  
Steroid Regimen ◽  
Frequent Relapse

Background: In pediatric patients with steroid-sensitive nephrotic syndrome, recent trials have revealed that a 2-month, short-term steroid regimen is not inferior to an extended steroid course. However, the optimal duration of initial steroid therapy for adult steroid-sensitive minimal change disease (MCD) remains unclear. Objectives: The aim of present study was to evaluate the effectiveness of a 2-month, short-term steroid regimen in the treatment of adult steroid-sensitive MCD patients. Method: This was a prospective observational study. Adult patients with steroid-sensitive MCD (n = 35) who were initiated on a short-term steroid regimen between January 2015 and June 2016 were included. The details of the regimen are as follows: (1) prednisolone was administered at an initial dose of 0.8–1.0 mg/kg/day and continued for 4–6 weeks and (2) dosage was reduced to 0.5–0.6 mg/kg/alternate day and continued for 4 weeks. Control patients (n = 140), who were treated using conventional steroid administration, were selected from our previous adult MCD cohort. All patients fulfilled the following criteria: biopsy-proven MCD, age ≥20 years, first episode of nephrotic syndrome, and attainment of complete remission within 4 weeks. The following parameters of patients who received short-term treatment regimen and control patients were compared: any relapse and frequent relapse, adverse events caused by steroid treatment and cumulative steroid dose. Results: Throughout the observation period (median: 17.3 months), 24 (68.6%) patients in the short-term group developed at least one relapse. The short-term regimen showed earlier occurrence of any relapse than the conventional regimen (adjusted hazard ratio [aHR] 2.45; 95% CI 1.51–3.97; p < 0.001), but there was no difference in frequent relapse (aHR 1.31; 95% CI 0.43–3.99; p = 0.63). None of the patients showed any symptoms of adrenal insufficiency after discontinuation of corticosteroids. The cumulative steroid dose during the observational period was significantly lower in the short-term group than in the conventional group. Conclusions: The short-term steroid regimen may represent an effective treatment option that ensures lower steroid exposure when treating adult steroid-sensitive MCD patients.

scholarly journals Tumor Necrosis Factor Alpha-863 C/A Single Nucleotide Polymorphisms and Nephrotic Syndrome

2020 ◽  
Vol 10 (03) ◽  
pp. 319-322
Author(s):  
Ahmed Abdul-Hassan Abbas ◽  
Zainab J. Fadhil ◽  
Shatha Hussein Ali
Keyword(s):  
Nephrotic Syndrome ◽  
Tumor Necrosis Factor ◽  
Serum Level ◽  
Tumor Necrosis ◽  
Nucleotide Polymorphisms ◽  
Necrosis Factor Alpha ◽  
Single Nucleotide ◽  
Tnf Α ◽  
Factor Alpha ◽  
Necrosis Factor

Introduction: Cytokines act as a mediator of inflammation in childhood nephrotic syndrome. Polymorphisms of cytokines genes may influence susceptibility to nephrotic syndrome (NS), as well as, patients’ steroid responses. Objective: To study the association of tumor necrosis factor-alpha single nucleotide polymorphisms (TNF-α SNP) (-863 C/A) with the development of NS in addition to access to their effects on serum level of TNF and the response to steroid therapy. Patients and Methods: This study included 60 patients (19 female and 41 male) with nephrotic syndrome; their ages ranged from 2 to 18 years. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to assess the TNF-α gene polymorphism. Results: According to the digestion pattern of RFLP-PCR products of TNF-α-863, this polymorphism had three genotypes, which were CC, CA, and AA, in both NS patients and controls. Also, the current result observed that -863 SNP do not affect the serum level of TNF-α and steroid responsiveness in patients with nephrotic syndrome. Conclusion: This polymorphism did not show any significant association with response to steroid therapy and TNF serum level neither at genotype nor at allele level.

scholarly journals Relationships between the clinical phenotypes and genetic variants associated with the immunological mechanism in childhood idiopathic nephrotic syndrome: protocol for a prospective observational single-centre cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028717
Author(s):  
Han Chan ◽  
Hao Lee ◽  
Xia Yang ◽  
Jingzhi Wang ◽  
Xueying Yang ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Cohort Study ◽  
Exome Sequencing ◽  
Genetic Variants ◽  
Idiopathic Nephrotic Syndrome ◽  
Single Centre ◽  
Clinical Phenotypes ◽  
Whole Exome ◽  
Medical University ◽  
Frequent Relapse

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

scholarly journals Comparison of eight-week and twelve-week corticosteroid treatment regimens in children with idiopathic nephrotic syndrome; A clinical trial

2020 ◽  
Vol 9 (3) ◽  
pp. e25-e25
Author(s):  
Hossein Emad Momtaz ◽  
Amin al Sadat Sharif ◽  
Ali Amri
Keyword(s):  
Clinical Trial ◽  
Nephrotic Syndrome ◽  
Relapse Rate ◽  
Steroid Treatment ◽  
Steroid Resistance ◽  
Treatment Protocols ◽  
Steroid Dependence ◽  
Treatment Groups ◽  
Treatment Regimens ◽  
Frequent Relapse

Introduction: Nephrotic syndrome (NS) is the commonest chronic glomerular disease in children. Idiopathic NS can perfectly be controlled using corticosteroids in most instances, but a significant relapse rate of NS is still a major problem. Several treatment protocols are suggested to decrease relapse rate of NS in children. Objectives: The current clinical trial aimed at comparing the relapse rate between two 8- and 12-week steroid treatment regimens. Patients and Methods: In the current non-randomized, clinical trial, a total of 68 children with primary NS were enrolled. Oral prednisolone was administered to 34 patients for eight weeks (2 mg/kg/d and 1.5 mg/kg/alternate-day/each for four weeks) and other 34 patients for 12 weeks (2 mg/kg/d and 1.5 mg/kg/alternate-day/each for six weeks). A one-year followup was completed for all the patients to evaluate relapse rate, steroid resistance, and steroid dependence. Results: The remission rates were 47.1% and 73.5%, respectively in children of the eight- and 12-week treatment groups because the difference was significant (P=0.026). The frequent relapse rates in the eight- and 12-week treatment groups were respectively 26.5% and 11.8%. Steroid dependence rate was 17.6% and 8.8% in the eight- and 12-week treatment groups respectively. The steroid resistance rates were respectively 8.8% and 5.9% in the eight- and 12-week treatment groups. Conclusion: Twelve-week steroid treatment can significantly decrease the relapse rate in comparison with eight-week treatment because no significant difference in steroid resistance, steroid dependence, and frequent relapse between the two treatment protocols was observed.

scholarly journals Relationship of Childhood Idiopathic Nephrotic Syndrome with Asthma, Hypertension, Complement C3, Urinalysis

2012 ◽  
Vol 35 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Ranjit Ranjan Roy ◽  
Md Rafiqul Islam ◽  
Abdul Matin ◽  
Rita Khan ◽  
Golam Muinuddi ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Idiopathic Nephrotic Syndrome ◽  
Disease Process ◽  
Complement C3 ◽  
Group 13 ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
The Difference ◽  
Frequent Relapse

A prospective observational study of 43 children with idiopathic nephrotic syndrome (INS) were selected randomly out of 480 children admitted with the disease at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2003 to January 2005. Aim of this study was to correlate the difference in frequency of atopic attack, hypertension, complement c3 level and urinalysis in different types of Idiopathic nephrotic syndrome. Result: Among 43 children with idiopathic nephrotic syndrome (INS), 24 children were steroid sensitive nephrotic syndrome (SSNS) and 19 children having steroid resistant nephrotic syndrome (SRNS) cases, of SSNS group 13 were infrequent relapse nephrotic syndrome (IFRNS) and 11 were frequent relapse steroid dependant nephrotic syndrome (FRNS + SDNS). Bronchial asthma and allergic dermatitis were found in about 63% cases of both steroid resistant nephrotic syndrome (SRNS) and frequent relapse steroid dependant (FRNS+SDNS) group. Hypertension was found in higher number of patient in SRNS compared to SSNS (P> 0.05) It was absent in IFRNS. Steroid contributed more than the disease process in producing hypertension (P< 0.01). Complement C3 comparison among the group could not reach statistically significant level. Similarly, comparison of hematuria showed no difference among the groups but pyuria was higher in SRNS compared to IFRNS (P >0.05). UTI were found equally in all the groups. Conclusion: Higher incidence of asthma, atopic dermatitis were noted in all the groups of idiopathic nephrotic syndrome (INS). C3 was not found significantly low in INS. Persistent elevation of blood pressure is found in higher number of SRNS compared to SSNS and steroid contributed more than the disease process. DOI: http://dx.doi.org/10.3329/bjch.v35i1.10367 BJCH 2011; 35(1): 11-15

scholarly journals Correlation between Serum Magnesium and Calcium Level in Children with Idiopathic Nephrotic Syndrome during Nephrosis

2017 ◽  
Vol 40 (3) ◽  
pp. 139-143
Author(s):  
Gulshan Nigar Chaudhury ◽  
Mohammed Hanif ◽  
Mahenaz Afroz ◽  
Dilruba Begum
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Magnesium ◽  
Magnesium Level ◽  
Cross Sectional ◽  
First Relapse ◽  
The Mean ◽  
Initial Episode ◽  
Frequent Relapse

Background: Biochemical alteration is a common phenomenon in all kidney disease including nephrotic syndrome (NS).Objective: To evaluate the magnesium (Mg) level in patients with nephrotic syndrome and its relation to calcium.Methods: In this observational cross sectional study,we measured serum magnesium and serum calcium levels in children with nephrotic syndrome.It was conducted in the Department of Pediatrics, Dhaka Shishu(children) Hospital, Dhaka, from January 2015 to June 2015. A total of fifty four diagnosed cases of nephrotic syndrome were divided into initial episode, first relapse,infrequent relapse and frequent relapse. Mean level of serum magnesium and calcium of all four groups were then compared.Results :The mean level of serum magnesium during initial episode was 2.28±0.36mg/ dl and it was 2.04±0.29,2.06±0.29 and 1.76±0.32mg/dl during first relapse, infrequent relapse and frequent relapse respectively. The mean serum magnesium level in different patterns of nephrotic syndrome was found to be statistically significant. Hypomagnesemia was mostly found in frequent relapse nephrotic syndrome patients. The mean level of serum calcium during initial episode was 2.01±0.16 and it was 1.98±0.17,2.06±0.13 and 2.05±0.15 during first relapse, infrequent relapse and frequent relapse respectively. The mean serum calcium level in different patterns of nephrotic syndrome was found to be statistically insignificant. There was no significant corelation between calcium level with magnesium level (r = -0.08, p = 0.28).Conclusion: Hypomagnesemia is commonly found in frequent relapse nephrotic syndrome. There was no significant correlation between calcium with magnesium level.Bangladesh J Child Health 2016; VOL 40 (3) :139-143

scholarly journals Comparisons of bone mineral density in steroid dependent, frequent relapse, and infrequent relapse nephrotic syndrome children

2010 ◽  
Vol 50 (4) ◽  
pp. 193 ◽  
Author(s):  
Lies Dewi Nurmala ◽  
Taralan Tambunan ◽  
Idham Amir
Keyword(s):  
Bone Mineral Density ◽  
Nephrotic Syndrome ◽  
Bone Mineral ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Mineral Density ◽  
Steroid Dependent ◽  
Group I ◽  
Z Scores ◽  
Frequent Relapse

Background Children with nephrotic syndrome, especially those with steroid dependent and frequent relapse are at greater risk of reduced bone mineral density (BMD).Objective To determine bone mineral density (BMD) in steroid dependent and frequent relapse compared to infrequent relapse nephrotic syndrome.Methods We conducted a cross-sectional study at the Child Health Department, Cipto Mangunkusumo Hospital, from August until November 2009. Subjects were 5 to 18 year-old children with steroid dependent nephrotic syndrome (SDNS), frequent relapsenephrotic syndrome (FRNS), or infrequent relapse nephrotic syndrome (IRNS). Ionized calcium level, vitamin 25(OH)D3 level, and BMD were measured us ng dual energy x-ray absorptiometry (DEXA).Results 11 SDNS and 11 FRNS cbildren (group I) were compared with 22 IRNS children (Group II). Children of SDNS and FRNS had significantly longer duration of illness, more relapses, longer steroid therapy duration, and greater cumulative steroid dose compared to group 11 (IRNS). There were no differences between  the two groups with regard to mean ionized calcium level and vitamin 25(OH)D3 level. Children in group I had lower z-scores compared to group lI, but the difference was not statistically significant r mean (SD) -1.182 (1.21) vs. -0.795 (1.25), P=0.305]. Subgroup analysis showed that SDNS children had lower z-scores than FRNS [-1.791 (1.17) vs. -0.57 (0.94), P=0.019] and IRNS [-1.791 (1.17) vs. -0.795 (1.25), P=O.026].Conclusion Children with SDNS have significantly lower BMD z-scores compared to those with FRNS and IRNS.

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