ESPN 50th Annual Meeting

ESPN 2017


 
CHILDHOOD STEROID-DEPENDENT IDIOPATHIC NEPHROTIC SYNDROME: PREDICTIVE FACTORS FOR THE NEED OF IMMUNOSUPPRESSIVE TREATMENT
GOLAY MéLANIE AMOUROUX CYRIL FILA MARC DALLA VALE FABIENNE ICHAY LYDIA TENENBAUM JULIE

1- CHU Montpellier
 
Introduction:

 Nearly half of the children with idiopathic nephrotic syndrome (SN) become steroid dependent and will later require the use of steroid sparing agents. It appears important to identify as early as possible those children in order to adapt their treatment.

The aim of our study was to analyse the population of children, under 18, diagnosed between 2000 and 2015 with SN to search for predictive criteria of the use of steroid-sparing agents. 
 

Material and methods:

 In this retrospective study, exclusion criteria were : primary steroid resistance and children free of  relapse of proteinuria.. 

Results:

 84 children (54 boys) were included. The mean follow-up duration was 5.5 years (0.75 to 16). Mean age at diagnosis was of 4.6 years old. 65 children (77%) received at least one steroid-sparing agent during their follow-up, with a mean delay of 10 months after diagnosis. In those patients, the first relapse occured earlier when compared  with the children who were maintained on steroid alone (4 monts vs 7 months p<0.001). The use of methylprednisolone pulses to obtain a remission, the cumulative dose of steroid treatment and the number of relapses of proteinuria were also signicantly correlated with the use of steroid sparing agents.

Conclusions:

 We did not find any predictive criteria of the use of steroid-sparing agents at diagnosis in our population of children. Nevertheless, with the steroid regimen used, the time of occurence of the first relapse of proteinuria appears to be a significant criteria for the secondary use of steroid-sparing agent. This data should be taken into account for the choose of the treatment regimen proposed.