Association between Immunoglobulin M and Steroid Resistance in Children with Nephrotic Syndrome: A Retrospective Multicenter Study in Japan

The prognosis of steroid-resistant nephrotic syndrome (SRNS) in children is poorer than steroid-sensitive cases. Diagnosis of SRNS is made after observing the response to the initial 4-week corticosteroid therapy, which might be accompanied by side effects. However, predictive indicators at initial...

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Bibliographic Details
Published in:Kidney360 2021-03, Vol.2 (3), p.487-493
Main Authors: Udagawa, Tomohiro, Matsuyama, Yusuke, Okutsu, Mika, Motoyoshi, Yaeko, Okada, Mari, Tada, Norimasa, Kikuchi, Eriko, Shimoda, Masuhiro, Kanamori, Toru, Omori, Tae, Takahashi, Masaki, Imai, Kohsuke, Endo, Akifumi, Fujiwara, Takeo, Morio, Tomohiro
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Female
Humans
Immunoglobulin M - therapeutic use
Japan - epidemiology
Male
Nephrotic Syndrome - diagnosis
Original Investigations
Retrospective Studies
Steroids - therapeutic use
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Summary:The prognosis of steroid-resistant nephrotic syndrome (SRNS) in children is poorer than steroid-sensitive cases. Diagnosis of SRNS is made after observing the response to the initial 4-week corticosteroid therapy, which might be accompanied by side effects. However, predictive indicators at initial diagnosis remain unknown. We aimed to investigate whether selectivity index (SI) and other indicators at initial diagnosis-for example, serum IgM and total serum protein-albumin ratio (TA ratio, total serum protein level over albumin level)-can predict SRNS. A total of 80 children were enrolled from seven hospitals in Japan between January 2008 and December 2019 (mean age, 4.7 years; 65% male). Of the children enrolled, 13 (16%, M/F=5:8) had been diagnosed as steroid resistant after initial treatment with steroids. The association between serum IgM (tertile categories: low, 24-133; middle, 134-169; and high, 169.1-510 mg/dl), SI (
ISSN:2641-7650
2641-7650
DOI:10.34067/KID.0004432020