A side effects of steroid & second line steroid sparing agents in children diagnosed with frequently relapsing and steroid dependent nephrotic syndrome

Abstract

Introduction: Nephrotic syndrome is a prevalent kidney disorder in children, affecting approximately 11.6 per 100, 000 children, with a male-to-female ratio of 1.3:1. Current interventions have been advanced to increase the survival rate below 3%. Although steroids are the mainstay of therapy, non-steroidal immunomodulating agents are also employed to reduce the side effects of corticosteroids and promote long-term cure. Objectives: The purpose of this research is to evaluate adverse effects of steroids and other immunosuppressive agents in paediatric nephrotic syndrome patients, to determine the drug-related morbidity, improve the patients’ quality of life, and thereby maintain remission. Materials and Methods: This cross-sectional, archival study involved children 1-18 years who were diagnosed with nephrotic syndrome and sought care at the Pediatric Nephrology Consult Clinic, Al-Zahraa Teaching Hospital, Wasit, Iraq over the period of 2017 to 2024. From a total of 206 patients with nephrotic syndrome, 93 patients with steroid-dependent and frequently relapsing disease were enrolled. Each individual also received a clinician assessment and biological assessments with recurrent assessment. Inclusion Criteria: Children and adolescents, one to eighteen years of age with steroid dependent and frequently relapse nephrotic syndrome under steroid and/or immunosuppressive treatment. Exclusion Criteria: These populations have been excluded; patients older than 18 yr, those with steroid-resistant or steroid-sensitive nephrotic syndrome, the atypical, patients with incomplete clinical records, congenital and infantile nephrotic syndrome, and nephrotic syndrome secondary to systemic diseases such as diabetes, Henoch-Schonlein purpura, and SLE. Informed Consent: All participants were briefed of the purpose of the study and agreed verbally to use their data in the study thereby maintaining anonymity and ethical practices. Results and Discussion: Out of the 93 patients, 60.2% were found to have frequently relapsing nephrotic syndrome (FRNS) and 39.8% to have steroid-dependent nephrotic syndrome (SDNS). The majority of these patients were male (2.3). These results are slightly higher than those of previous research projects with similar designs (p