Long-term outcome of biopsy-proven minimal-change nephrotic syndrome in Chinese children

Vickie Wai-Ki Kwong, Bonnie Ching-Ha Kwan, Kai-Ming Chow, Chi-Bon Leung, Philip Kam-Tao Li, Cheuk-Chun Szeto
2013 Hong Kong Journal of Nephrology  
Previous studies have shown that up to 40% of childhood-onset minimal-change nephropathy (MCN) cases persist after puberty. However, data are scarce concerning the long-term renal prognosis and prevalence of treatment-related complications of this group of patients after they become adults. Materials and methods: The clinical records of 55 consecutive pediatric patients with biopsyproven MCN treated in our hospital from 1984 to 2004 were reviewed to evaluate the disease pattern, treatment
more » ... rn, treatment regimen, and the development of treatment-related complications. Results: Of the 55 patients treated, 35 were followed after age 18 years; 13 (37%) had relapses during adulthood. Treatment-related complications were observed in 20 patients (57%), including being overweight (23%), impaired fasting glucose (14%), infertility (14%), persistent low grade proteinuria (11%), fracture (9%), and hypertension (9%). All patients had normal renal function when last assessed. Conclusion: A substantial proportion of patients with childhood-onset MCN continued to have relapse after they became adults. Although almost all patients have normal renal function, prolonged use of steroid and immunosuppressive agents results in a considerable risk of treatmentrelated complications. Life-long follow-up seems advisable for this group of patients, not only for detecting relapses, but also to allow timely diagnosis of treatment-related complications.
doi:10.1016/j.hkjn.2013.03.004 fatcat:ozr34ftgffcuhen3tr66sfkxfu