الفهرس | Only 14 pages are availabe for public view |
Abstract Nephrotic syndrome is the most common glomerular disease in childhood. Failure to achieve remission despite treatment with steroids is classified as steroid resistant nephrotic syndrome (SRNS). Eighty patients with SRNS were enrolled in the study; 52.2% males and 47.5% females. Forty-seven patients (58.8%) were born to consanguineous parents. The median age of the cases was 6 years (age ranged: 1 month -18 years). Clinical course of the disease including complications, all the immunosuppressive drugs given and age of end-stage renal disease (ESRD) were reviewed. Clinical examination emphasized on anthropometric measurements of growth and malnutrition. Growth velocity and renal survival were calculated. Insulin like growth factor -1 (IGF-1) was performed in all patients in addition to bone age in patients with height SDS less than -2. Short stature was observed in 47.5% of patients and serum IGF-1 was low in 62.5% of all patients and in 58% of patients with short stature. At the end of the study, 36 patients (43.7%) progressed to ESRD; 24 patients were on regular hemodialysis, 12 patients (15%) were transplanted, and 13 patients died mainly due to infections. We conclude that steroid resistant nephrotic syndrome is a chronic glomerular disease with many comorbidities affecting the quality of life of children, including growth retardation, chronic kidney disease, malnutrition and infections |