| Long-term Follow-up Study of Children with Minimal Change Nephrotic Syndrome |
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Jung Sue Kim1, Hae Il Cheong1, Hyun Soon Lee2, Yong Choi1 |
1Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
2Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea |
| 소아 미세변화 신증후군 : 치료 반응도 및 장기 추적 관찰 |
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김정수1, 정해일1, 이현순2, 최용1 |
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 해부병리학교실 |
Correspondence:
Yong Choi, Email: 1
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| Abstract |
Purpose
: Most of childhood MCNS has a long disease course with frequent relapses. This study was designed to analyze the long-term clinical course of childhood MCNS, focusing at relapsing pattern, treatment response and complications.
Mothods : The medical records of 137 children with biopsy-proven MCNS observed during 1976 ti 1996 were analyzed retrospectively. They were classified as initial responders(111 patients, 81%) and nonresponders(26 patients, 19%) according to the response to initial oral prednisolone(60mg/m2/d) for 4 weeks. The detailed clinical courses were obtained in 126 patients.
Results
: The incidences of hematuria, hypertension and azotemia were more frequent in initial responders than nonresponders. During follow-up, the proportion of patients with sustained remission increased gradually with decreasing rate of relapse. At the last follow-up, 77 patients (61%) revealed sustained remission, 36(29%) repeated relapses, 9(7%) persistent proteinuria, 3(2%) renal failure, and 1(1%) death. The responses to secondary drugs such as first and second course
of cyclophosphamide, cyclosporin, levamisole and methylprednisolone pulse were 80%, 85.7%, 70%, 75%, and 40%, respectively. Major complications were infections including peritonitis(29 patients) and acute renal failure(10).
Conclusion
: Long-term prognosis of childhood MCNS is determined by clinical courses rather than renal pathology. Although majority of childhood MCNS reveal good long-term prognosis, patients did well, few patients do not so. Early detection and more aggressive therapy of such patients are very helpful. |
| Key Words:
Minimal change nephrotic syndrome, Long-term follow-up |
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