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Abstract: FR-PO661

Long-Term Complications in Patients With Childhood-Onset Nephrotic Syndrome: A Report From a Tertiary Care Center in India

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Author

  • Bharati, Joyita, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
Background

Childhood-onset nephrotic syndrome (NS), although commonly steroid-sensitive, is associated with long-term complications such as obesity, osteoporosis, growth failure, and hypertension. Reports on long-term complications of childhood-onset NS are mostly from developed countries not representing South-Asian ethnicities. Further, data on cardiovascular health among older children and young adults with childhood-onset NS are limited.

Methods

This was an observational study involving patients attending a tertiary care center. Patients aged 15 years or older, identified from the database of childhood-onset NS attending an adult renal clinic, were examined for long-term complications and long-term remission of NS at their visit in December 2021. Childhood-onset NS meant onset of NS before 10 years of age. Long-term complications included obesity, growth failure, low bone mineral density (BMD) Z score, hypertension, and increased carotid intima-media thickness (cIMT). Long-term remission was defined as no relapse for the last 3 consecutive years without immunosuppressive medication to maintain remission.

Results

Of 101 patients studied (~80% with frequent relapsing (FR)/steroid-dependent (SD)NS), the mean age was 17.6 (2.4) years at the time of the study. Long-term complications were noted in 89.1% of patients which included one or more of the following- obesity (22.7%), growth failure (31.7%), low BMD Z score (53.5%), hypertension (31.7%), and high cIMT (50.5%). Thirty-nine (38.6%) patients were in long-term remission at the time of the study. Growth failure and low BMD Z scores were less frequent in patients with long-term remission compared to those without long-term remission.

Conclusion

In Indian patients with childhood-onset NS (predominantly FR/SDNS) who were studied at 15 years of age, ~90% had long-term complications which included high cIMT in 50%. Only ~40% were in long-term remission.