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Article: Idiopathic minimal change nephrotic syndrome in older adults: Steroid responsiveness and pattern of relapses

TitleIdiopathic minimal change nephrotic syndrome in older adults: Steroid responsiveness and pattern of relapses
Authors
KeywordsAdult
Clinical outcome
MCNS
Minimal change nephrotic syndrome
Relapse
Responsiveness
Steroid
Issue Date2003
PublisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/
Citation
Nephrology Dialysis Transplantation, 2003, v. 18 n. 7, p. 1316-1320 How to Cite?
AbstractIntroduction. Minimal change nephrotic syndrome (MCNS) is a common form of nephrotic syndrome in children and young adults. We investigated its clinical presentations, steroid responsiveness, subsequent clinical course and patterns of relapse in older adults in whom it was diagnosed after the age of 50 years. Methods. The clinical records of renal patients followed-up in a single out patient clinic were retrieved and those patients with biopsy-proven MCNS were included. Patients in the 18-50-year age range (Group A) at the time of biopsy were compared with those older than 50 years (Group B) with regard to baseline demographic data, clinical features and outcome of treatment. Results. In all, 50 patients were studied, 35 in Group A (age at diagnosis: 38.8±11.91 years) and 15 in Group B (age at diagnosis: 70±6.85 years), with an overall follow-up duration of 72.08±63.42 months. Group B had a higher prevalence of hypertension and lower creatinine clearance at presentation, but the values of creatinine clearance for both groups were comparable with age-matched controls. One patient from Group B and two from Group A had spontaneous remission. Complete remission was achieved in 9.09, 45.45, 90.91 and 100% of Group B patients and 15.63, 62.5, 87.5 and 93.75% of Group A patients after 2, 4, 8 and 16 weeks of steroid therapy, respectively. The median time to complete remission and the duration of steroid treatment were similar for both groups. From Group B five patients and 22 patients from Group A relapsed during follow-up (P=0.055), with similar proportions of each group being early relapsers or frequent relapsers. The average number of relapses was 2.06 episodes for Group A, compared with 0.87 episodes for group B (P=0.062). Second agents were used in 20 Group A and four Group B patients (P=0.048). Complications of treatment were more common in Group A. None of the patients developed doubling of serum creatinine during follow-up. Conclusions. Clinical presentations of older patients with MCNS were similar to younger patients apart from the age-related decline of renal function and higher prevalence of hypertension. Both groups have similar steroid responsiveness, but older patients tend to have fewer relapses and require fewer second agents for treatment of relapses.
Persistent Identifierhttp://hdl.handle.net/10722/77455
ISSN
2015 Impact Factor: 4.085
2015 SCImago Journal Rankings: 1.780
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, KCen_HK
dc.contributor.authorLam, MFen_HK
dc.contributor.authorYip, PSen_HK
dc.contributor.authorLi, FKen_HK
dc.contributor.authorChoy, BYen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChan, TMen_HK
dc.date.accessioned2010-09-06T07:32:05Z-
dc.date.available2010-09-06T07:32:05Z-
dc.date.issued2003en_HK
dc.identifier.citationNephrology Dialysis Transplantation, 2003, v. 18 n. 7, p. 1316-1320en_HK
dc.identifier.issn0931-0509en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77455-
dc.description.abstractIntroduction. Minimal change nephrotic syndrome (MCNS) is a common form of nephrotic syndrome in children and young adults. We investigated its clinical presentations, steroid responsiveness, subsequent clinical course and patterns of relapse in older adults in whom it was diagnosed after the age of 50 years. Methods. The clinical records of renal patients followed-up in a single out patient clinic were retrieved and those patients with biopsy-proven MCNS were included. Patients in the 18-50-year age range (Group A) at the time of biopsy were compared with those older than 50 years (Group B) with regard to baseline demographic data, clinical features and outcome of treatment. Results. In all, 50 patients were studied, 35 in Group A (age at diagnosis: 38.8±11.91 years) and 15 in Group B (age at diagnosis: 70±6.85 years), with an overall follow-up duration of 72.08±63.42 months. Group B had a higher prevalence of hypertension and lower creatinine clearance at presentation, but the values of creatinine clearance for both groups were comparable with age-matched controls. One patient from Group B and two from Group A had spontaneous remission. Complete remission was achieved in 9.09, 45.45, 90.91 and 100% of Group B patients and 15.63, 62.5, 87.5 and 93.75% of Group A patients after 2, 4, 8 and 16 weeks of steroid therapy, respectively. The median time to complete remission and the duration of steroid treatment were similar for both groups. From Group B five patients and 22 patients from Group A relapsed during follow-up (P=0.055), with similar proportions of each group being early relapsers or frequent relapsers. The average number of relapses was 2.06 episodes for Group A, compared with 0.87 episodes for group B (P=0.062). Second agents were used in 20 Group A and four Group B patients (P=0.048). Complications of treatment were more common in Group A. None of the patients developed doubling of serum creatinine during follow-up. Conclusions. Clinical presentations of older patients with MCNS were similar to younger patients apart from the age-related decline of renal function and higher prevalence of hypertension. Both groups have similar steroid responsiveness, but older patients tend to have fewer relapses and require fewer second agents for treatment of relapses.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/en_HK
dc.relation.ispartofNephrology Dialysis Transplantationen_HK
dc.rightsNephrology, Dialysis, Transplantation. Copyright © Oxford University Press.en_HK
dc.subjectAdulten_HK
dc.subjectClinical outcomeen_HK
dc.subjectMCNSen_HK
dc.subjectMinimal change nephrotic syndromeen_HK
dc.subjectRelapseen_HK
dc.subjectResponsivenessen_HK
dc.subjectSteroiden_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAge Factorsen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAnti-Inflammatory Agents - therapeutic useen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNephrosis, Lipoid - drug therapy - pathologyen_HK
dc.subject.meshOutcome Assessment (Health Care)en_HK
dc.subject.meshPrednisolone - therapeutic useen_HK
dc.subject.meshRecurrenceen_HK
dc.subject.meshRemission Inductionen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshTime Factorsen_HK
dc.titleIdiopathic minimal change nephrotic syndrome in older adults: Steroid responsiveness and pattern of relapsesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0931-0509&volume=18&issue=7&spage=1316&epage=1320&date=2003&atitle=Idiopathic+minimal+change+nephrotic+syndrome+in+older+adults:+steroid+responsiveness+and+pattern+of+relapsesen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid12808168-
dc.identifier.scopuseid_2-s2.0-0038691558en_HK
dc.identifier.hkuros79065en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038691558&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue7en_HK
dc.identifier.spage1316en_HK
dc.identifier.epage1320en_HK
dc.identifier.isiWOS:000183929000015-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridLam, MF=36879142300en_HK
dc.identifier.scopusauthoridYip, PS=14219904600en_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK
dc.identifier.scopusauthoridChoy, BY=7003465499en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK

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