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Kidney Week

Abstract: SA-PO681

Oval Fat Bodies in Urinary Sediment Microscopy Can Be a Convenient Prognostic Marker for Idiopathic Nephrotic Syndrome in Children

Session Information

  • Pediatric Glomerular Disease
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Matsumura, Hideki, Osaka Medical College, Takatsuki, Osaka-Fu, Japan
  • Yamazaki, Satoshi, Osaka Medical College, Takatsuki, Osaka-Fu, Japan
  • Fujii, Yuko, Osaka Medical College, Takatsuki, Osaka-Fu, Japan
  • Shirasu, Akihiko, Osaka Medical College, Takatsuki, Osaka-Fu, Japan
  • Tanaka, Tomoko, Osaka Medical College, Takatsuki, Osaka-Fu, Japan
  • Nakakura, Hyogo, Osaka Medical College, Takatsuki, Osaka-Fu, Japan
  • Hattori, Motoshi, Tokyo Women's Medical University, Tokyo, ToKyo, Japan
  • Ashida, Akira, Osaka Medical College, Takatsuki, Osaka-Fu, Japan
Background

Recently, genetic testing for steroid-resistant nephrotic syndrome has been applied to diagnosis and treatment, but it is not a simple test because of the time and cost. Meanwhile, urine microscopy is the oldest and one of the most commonly used tests for diagnosis of kidney disease. It is generally considered that oval fat bodies and fatty casts in urine sediments are seen in nephrotic syndrome, but in fact oval fat bodies and fatty casts are rarely detected in pediatric idiopathic nephrotic syndrome, and sometimes they are detected in steroid-resistant nephrotic syndrome. However, the significance of oval fat bodies and fatty casts in pediatric idiopathic nephrotic syndrome has rarely been investigated.
In this study, we investigated whether oval fat bodies and fatty casts could be a prognostic predictor of steroid-resistant nephrotic syndrome in children with idiopathic nephrotic syndrome.

Methods

We retrospectively reviewed medical records of pediatric patients with idiopathic nephrotic syndrome who were being treated at our department. The study items were steroid sensitivity in the nephrotic syndrome, the grade of CKD, and the presence of oval fat bodies and fatty casts in the urine sediments at the onset and recurrence.

Results

Of the 45 patients, 11 had oval fatty bodies and/or fatty casts. These sediments were present in 8/13 (62%) of patients with steroid-resistant nephrotic syndrome versus only 3/32 (13%) of patients with steroid-sensitive nephrotic syndrome. In patients with CKD, they were observed continuously in all patients, while in those with steroid-sensitive nephrotic syndrome, they were observed only once or twice.

Conclusion

In children with idiopathic nephrotic syndrome, those who continue to have oval fat bodies or fatty casts are more likely to be steroid-resistant and have a poor kidney prognosis. In the present study, oval fat bodies and fatty casts in the urine sediment were found to be poor prognostic markers in children with idiopathic nephrotic syndrome.