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