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Initial steroid sensitivity in children with steroid-resistant nephrotic syndrome predicts post-transplant recurrence
- Source :
- Journal of the American Society of Nephrology : JASN. 25(6)
- Publication Year :
- 2014
-
Abstract
- Of children with idiopathic nephrotic syndrome, 10%–20% fail to respond to steroids or develop secondary steroid resistance (termed initial steroid sensitivity) and the majority progress to transplantation. Although 30%–50% of these patients suffer disease recurrence after transplantation, with poor long-term outcome, no reliable indicator of recurrence has yet been identified. Notably, the incidence of recurrence after transplantation appears reduced in patients with steroid-resistant nephrotic syndrome (SRNS) due to monogenic disorders. We reviewed 150 transplanted patients with SRNS to identify biomarkers that consistently predict outcome of SRNS after transplantation. In all, 25 children had genetic or familial SRNS and did not experience post-transplant recurrence. We reviewed phenotypic factors, including initial steroid sensitivity, donor type, age, ethnicity, time to ESRD, and time on dialysis, in the remaining 125 children. Of these patients, 57 (45.6%) developed post-transplant recurrence; 26 of 28 (92.9%) patients with initial steroid sensitivity recurred after transplantation, whereas only 26 of 86 (30.2%) patients resistant from the outset recurred (odds ratio, 30; 95% confidence interval, 6.62 to 135.86; P
- Subjects :
- Male
Pathology
medicine.medical_specialty
Nephrotic Syndrome
Adolescent
medicine.medical_treatment
Population
Drug Resistance
Gastroenterology
Age Distribution
Recurrence
Renal Dialysis
Risk Factors
Clinical Research
Internal medicine
Medicine
Humans
Age of Onset
education
Child
Kidney transplantation
Dialysis
education.field_of_study
business.industry
Surrogate endpoint
Infant
General Medicine
Odds ratio
medicine.disease
Kidney Transplantation
Steroid-resistant nephrotic syndrome
Transplantation
Nephrology
Child, Preschool
Kidney Failure, Chronic
Female
Steroids
business
Transcriptome
Nephrotic syndrome
Biomarkers
Subjects
Details
- ISSN :
- 15333450
- Volume :
- 25
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of the American Society of Nephrology : JASN
- Accession number :
- edsair.doi.dedup.....72e73426edc4cf828371cc94ffbf0f38