Childhood Nephrotic Syndrome Management and Outcome: A Single Center Retrospective AnalysisReport as inadecuate

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International Journal of Nephrology - Volume 2017 2017, Article ID 2029583, 7 pages -

Research Article

Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA

Children’s Healthcare of Atlanta, 1677 Tullie Circle, Atlanta, GA 30329, USA

Correspondence should be addressed to Chia-shi Wang

Received 30 December 2016; Revised 9 February 2017; Accepted 12 February 2017; Published 23 February 2017

Academic Editor: Jochen Reiser

Copyright © 2017 Chia-shi Wang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


There is a paucity of information on outpatient management and risk factors for hospitalization and complications in childhood nephrotic syndrome NS. We described the management, patient adherence, and inpatient and outpatient usage of 87 pediatric NS patients diagnosed between 2006 and 2012 in the Atlanta Metropolitan Statistical Area. Multivariable analyses were performed to examine the associations between patient characteristics and disease outcome. We found that 51% of the patients were treated with two or more immunosuppressants. Approximately half of the patients were noted to be nonadherent to medications and urine protein monitoring. The majority 71% of patients were hospitalized at least once, with a median rate of 0.5 hospitalizations per patient year. Mean hospital length of stay was 4.0 3.8 days. Fourteen percent of patients experienced at least one serious disease complication. Black race, frequently relapsing-steroid-dependent and steroid-resistant disease, and the first year following diagnosis were associated with higher hospitalization rates. The presence of comorbidities was associated with longer hospital length of stay and increased risk of serious disease complications. Our results highlight the high morbidity and burden of NS and point to particular patient subgroups that may be at increased risk for poor outcome.

Author: Chia-shi Wang, Jia Yan, Robert Palmer, James Bost, Mattie Feasel Wolf, and Larry A. Greenbaum



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