Indian Journal of Innovative Clinical Research

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CLINICO-BIOCHEMICAL PROFILE AND KEY INDEPENDENT RISK FACTORS FOR FREQUENT RELAPSE IN CHILDHOOD STEROID-SENSITIVE NEPHROTIC SYNDROME

Article Information

Hemant Kumar, ex-Professor, Department of Nephrology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

Introduction: Steroid-sensitive nephrotic syndrome (SSNS) is the most common form of nephrotic syndrome in children, accounting for 85-90% of cases. Although SSNS responds well to corticosteroids, frequent relapses are common, complicating long-term management. Identifying clinical and biochemical risk factors for frequent relapse is crucial to optimizing treatment and minimizing steroid-related side effects. This study evaluated the biochemical profile and clinical range of kids with SSNS and found independent risk factors for relapsing frequently.

Methods: Based on the International research of Kidney Disease in Children (ISKDC) criteria, 40 children between the ages of 1 and 15 who had been diagnosed with SSNS underwent a prospective observational research. Data from clinical and laboratory settings were gathered, including standard biochemical and haematological assays. Complications, frequency of relapse, and response to steroids were observed throughout a one-year follow-up period. To find important risk factors for relapsing frequently, statistical analysis was done using Fisher's exact test and Chi-square.

Results: Of the 40 children, 55% experienced at least one relapse during the follow-up period, with 35% having frequent relapses. Younger age at presentation (mean 4.9 ± 1.9 years, p = 0.002), delayed steroid response (mean time to remission 18 days, p = 0.001), and elevated CRP levels (p = 0.03) were identified as independent risk factors for frequent relapse. No major complications, such as steroid toxicity, were observed, though 7.5% developed mild hypertension.

Conclusion: This study found that younger age, delayed steroid response, and elevated inflammatory markers are significant predictors of frequent relapse in children with SSNS. Early identification of these risk factors may help tailor treatment and reduce the burden of frequent relapses.

Keywords: Steroid-Sensitive Nephrotic Syndrome, SSNS, Frequent Relapse, Children, Risk Factors, Corticosteroids