STEROID-RESPONSE PATTERN IN INDIAN CHILDREN WITH NEPHROTIC SYNDROME

The steroid response pattern to standard prednisolone therapy is of immense diagnostic, therapeutic and prognostic value for the treating physician in managing children with nephrotic syndrome. None of the studies from our country has analysed the clinical, biochemical and histopathological profile in different steroid response categories. To address this problem we conducted a study comprising 127 children with nephrotic syndrome referred to our Institute. They were treated with oral prednisolone according to the APN protocol. Based on the subsequent response these children were classified into different steroid response categories on follow-up. Of the 116 children with follow-up of more than six months, infrequent relapsers constituted the majority (37.9%). The frequency of other steroid response categories was as follows: frequent relapsers (21.6%), steroid-dependent (18.1%), initial nonresponders (17.3%) and subsequent non-responders (5.1%). The factors predicting a poor response to standard prednisolone therapy in our study were age of onset more than eight years, male sex, hypertension, microscopic haematuria and presence of non-minimal change nephrotic syndrome lesions on histopathology.