THE FACTORS THAT AFFECT THE RELAPSES AND THEIR PROGNOSTIC SIGNIFICANCE IN CHILDHOOD IDIOPATHIC NEPHROTIC SYNDROME

Retrospective analysis of 113 children with idiopathic nephrotic syndrome (INS) was performed between January 1990 and January 1995. The mean age of the patients was 3.9 years and male/female ratio was 1.3. All the patients had edema at first admission while 60 had infection. Steroid therapy was started on 109 patients. One hundred and two patients had remission while 7 (6.4 %) patients did not respond. At least one relaps developed in 46.9 % of patients and most of the first relapses occured within the first year. Occurence of relapses was found to be more frequent in the patients who received albumin infusion. Number of relapses in the patients whose follow up period is more than two years were higher in male patients and whose initiation of the disease is after 3 years of age. Thirty four percentage of the relapses were associated with infection. Two patients died because of infection (1.8 %). Fifteen patients had spontaneous remission in different stages of the disease and 8 patients (7.1 %) developed frequent relapses. Fifteen patients with frequent relapses or steroid dependent and steroid resistant nephrotic syndrome were given cyclophosphamide therapy and 3 nonresponders were administered chlorambucil with a good result. In this study we showed once more that INS is frequent in childhood, infection is an important factor that affect the mortality and morbidity of the disease, relapses are more frequent in males and in patients whose disease onset is after 3 years of age and with appropriate therapy its mortality is low with a good prognosis.