All issues > Volume 27(3); 1984

Original Article

J Korean Pediatr Soc. 1984;27(3):246-252. Published online March 31, 1984.

Clinical Observation about complications(Especially about Mortality Cases) in Childhood Primary Nephrotic Syndrome.

Hae ll Cheong, Yong Choi, Kwang Wook Ko

¹Department of Pediatrics College of Medicine, Seoul National University

Abstract

Among 350 children who had been admitted to the Ward of Pediatrics, Seoul National University Hospital during the period from 1975.1.1. to 1983.12.31. and had been diagnosed as idiopathic nephrotic syndrome, total 21 cases (6%) had expired or had progressed into end stage renal disease during follow-up. Among these, 13 cases(61.9%； Group A) had expired due to chronic renal failure or had progressed into end stage renal disease and 8 cases (38.1%; Group B) had expired due to other causes. In Group A patients, the mean age at the onset of nephrotic syndrome was 7yr 4mo and male to female ratio was 7 : 6 and in Group B patients, the mean age at onset was 6yr 3mo and the sex ratio was 5:3. In 12 children among group A and 4 among Group B, kidney needle biopsy was done during admission. On the 1st admission, hypertension and glycosuria were accompanied more frequently and the responsiveness to the initial daily steroid therapy was poorer in Group A than in Group B children. The pathologic finding of kidney biopsy was non-minimal change lesion in almost all cases of Group A patients with focal and segmental glomerulosclerosis as a leading one, while that of most of Group B patients with kidney biopsy was minimal change lesion. And active crescent formation was noted only in Group A patients with, a frequency of 66.7%. In Group A, the mean disease duration between the age at the onset of nephrotic syndrome and the age at death was 4yr 4mo, while in Group B, 2yr 6mo. And among Group A patients, those with focal and segmental glomerulosclerosis had a more insidious course to chronic renal failure than those with non-focal and segmental glomerulosclerosis lesion, and among Group B patients, those with biopsy-proven minimal change lesion expired later in the disease course than others. Finally, bacterial and viral infections were the main causes of death in most of Group B patients (87.5%).

Keywords :Childhood primary nephrotic syndrome; Mortality cases; Cause of death