Complications of Children with Nephrotic Syndrome Hospitalized at Imam Hossein Pediatric Hospital, Isfahan, Iran

Document Type : Original Article (s)

Authors

1 Nurse, Imam Hossein Pediatric Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Epidemiologist, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: International studies show that every year, 2-7 new cases of primary nephrotic syndrome in every 100,000 children of under-16-year age occur and its prevalence is 15.7 per 100,0000 children. Nephrotic syndrome is diagnosed with high urinary protein excretion, low blood protein and high blood lipids.Methods: This retrospective study was done to determine the incidence of complications related to nephrotic syndrome in children. All the children with nephrotic syndrome admitted in Imam HosseinPediatric Hospital, Isfahan, Iran, during 2013-2014, entered the study. Information such as age, sex, systolic and diastolic blood pressure (mmHg), length of hospitalization (day), number of relapses, albumin (g/dl), creatinine (g/dl), cholesterol (mg/dl), triglycerides (mg/dl) and urine protein levels (mg/24 hours) and glomerular filtration rate (GFR) (mg/minute) of the patient were collected from their last medical records.Findings: The mean age of patients was 21.8 with a standard deviation of 8.3 years. The most frequent age was 5 years old. 39.3% of patients had increased systolic blood pressure and 36.4% of them had high diastolic blood pressure. In addition, 90.3% of patients had abnormal blood fat (triglycerides or cholesterol increase). 41.9% and 88.4% of patients had impaired albumin and glomerular filtration rates, respectively. 58.0% of patients had +++ proteinuria, as well as 20.2% of them had ++++ proteinuria.Conclusion: Since the treatment and recovery of patients with nephrotic syndrome is very slow and time-dependent and there is not full recovery, we must recognize the symptoms and prevent progression to symptomatic treatment of the diseases; risk factors should be taken to avoid creating secondary problems, too.

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  1. Mendoza SA, Tune BM. Management of the difficult nephrotic patient. Pediatr Clin North Am 1995; 42(6): 1459-68.
  2. Alshaya HO; Kari J. Levamisole treatment in steroid sensitive nephrotic syndrome. Saudi Med J 2002; 23(9): 1101-4.
  3. Goldblum SE, Reed WP. Host defenses and immunologic alterations associated with chronic hemodialysis. Ann Intern Med 1980; 93(4): 597-613.
  4. Loscalzo J. Venous thrombosis in the nephrotic syndrome. N Engl J Med 2013; 368(10): 956-8.
  5. Seimiya M, Ohno S, Asano H, Fujiwara K, Yoshida T, Sawabe Y, et al. Change in albumin measurement method affects diagnosis of nephrotic syndrome. Clin Lab 2014; 60(10): 1663-7.
  6. Soares SF, Donatti TL, Souto FJ. Serological markers of viral, syphilitic and toxoplasmic infection in children and teenagers with nephrotic syndrome: case series from Mato Grosso State, Brazil. Rev Inst Med Trop Sao Paulo 2014; 56(6): 499-504.
  7. Gulati S, Kher V, Arora P, Gupta S, Kale S. Urinary tract infection in nephrotic syndrome. Pediatr Infect Dis J 1996; 15(3): 237-40.
  8. Gulati S, Kher V, Gupta A, Arora P, Rai PK, Sharma RK. Spectrum of infections in Indian children with nephrotic syndrome. Pediatr Nephrol 1995; 9(4): 431-4.
  9. Wemmer U. Nephrotisches Syndrom. Available from: URL:http://www.kindernetzwerk.de/images/Krankheitsuebersichten/Krankheitsuebersichten-nephrotisches-syndrom.pdf. [In German].
  10. McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberger J, Rocchini AP, et al. Drug therapy of high-risk lipid abnormalities in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing. Circulation 2007; 115(14): 1948-67.
  11. Merouani A, Levy E, Mongeau JG, Robitaille P, Lambert M, Delvin EE. Hyperlipidemic profiles during remission in childhood idiopathic nephrotic syndrome. Clin Biochem 2003; 36(7): 571-4.
  12. Ataei N, Madani A, Falakolaflaki B. Evaluation of clinical course, rirsk factors for relapse and long-term outcome of children with primary nephrotic syndrome. Tehran Univ Med J 2003; 61(4): 308-19. [In Persian].
  13. Mahdavi Mazdeh M, Samimi R, Lesan Pezeshki M, Ahmadi F, Khatami MR, Seifi S, et al. To determine the correlation of the histological picture of rental biopsy specimens with clinical signs in cases of nephritic syndrome. Daneshvar Med 2005; 56(12): 53-6. [In Persian].