Evidence map›Paper›PMID 39218996›Full record

ArticleJournal of nephrology2024

Timing of relapse as a key indicator of steroid-sparing requirements in childhood idiopathic nephrotic syndrome.

Khairunnisa Mohamad, Hadzliana Zainal, Nur Arzuar Abdul Rahim, Tengku Hasnita Tengku Hussain

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Khairunnisa MohamadSchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
Hadzliana ZainalDiscipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia. hadz@usm.my.
Nur Arzuar Abdul RahimDepartment of Clinical Medicine, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
Tengku Hasnita Tengku HussainDepartment of Paediatric, Hospital Sultanah Nur Zahirah, Ministry of Health Malaysia, Terengganu, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManaging children with frequent relapses or steroid-dependent nephrotic syndrome poses challenges due to recurrent relapses necessitating prolonged steroid exposure, thus increasing susceptibility to long-term complications. Identifying those at risk of poor response to steroid therapy may be helpful to guide timely intervention with steroid-sparing agents. This study aimed to identify factors associated with steroid-sparing agent needs in children with frequent relapses or steroid-dependent nephrotic syndrome.

methodsA retrospective multicenter cohort study was conducted by reviewing the medical records of children with idiopathic nephrotic syndrome treated between 2006 and 2023. Cox proportional regression analyzed prognostic factors for steroid-sparing agent requirements in children with frequent relapses or steroid-dependent nephrotic syndrome. The time-to-event analysis utilizing the Kaplan-Meier estimate examined the proportion of children needing steroid-sparing agents after diagnosis.

resultsMedical records of 121 children (85 males) diagnosed with idiopathic nephrotic syndrome at a median age of 4.5 years (range 1.3-12.8) were reviewed over a median follow-up of 3.7 years (range 1.0-15.0). Time to subsequent relapse post-frequent relapses or steroid-dependent nephrotic syndrome diagnosis (at 3-month threshold) emerged as the sole significant predictor of steroid-sparing agent requirement, adjusted hazard ratio (aHR) = 2.26, 95% confidence interval (CI) 1.26-4.05. Kaplan-Meier analysis indicated that an earlier first relapse (< 3 months) led to earlier steroid-sparing agent requirement (log-rank p = 0.005). Children who relapsed within 3 months post-frequent relapses or steroid-dependent nephrotic syndrome diagnosis exhibited a higher frequency of relapses, a greater incidence of steroid-related adverse events, and were more likely to develop steroid dependency.

conclusionsEarly subsequent relapse following diagnosis of frequent relapses or steroid-dependent nephrotic syndrome was linked to earlier requirement of steroid-sparing agent therapy. Further prospective research is necessary to confirm this observation.

Indexed as

Nephrotic SyndromeRecurrenceSteroidsChildChild, PreschoolFemaleGlucocorticoidsHumansInfantKaplan-Meier EstimateMaleProportional Hazards ModelsRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeGlucocorticoidsSteroidsFrequent relapse or steroid dependentIdiopathic nephrotic syndromePredictorsSteroid-sparing agents

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.