Nephrotic Syndrome Relapse
Pediatr Nephrol (2007) 22:232–236 DOI 10.1007/s00467-006-0316-y
ORIGINAL ARTICLE
Triggers of relapse in steroid-dependent and frequently relapsing nephrotic syndrome
Shori Takahashi & Naohiro Wada & Hitohiko Murakami & Satoshi Funaki & Tetsuji Inagaki & Kensuke Harada & Michio Nagata
Received: 3 March 2006 / Revised: 3 August 2006 / Accepted: 17 August 2006 / Published online: 17 October 2006 # IPNA 2006
Abstract An awareness of the triggers of relapse is critical for the control of steroid-dependent, frequently relapsing nephrotic syndrome (SDFRNS). We have investigated the triggers, usually described as ‘episodes’, to such relapses within a temporal context. Thirty-five patients with SDFRNS were analyzed retrospectively. A total of 442 relapses occurred in 2499 patient-months. The relapses were classified into two groups: those with episodes (E+) and those without episodes (E−). There were 135 E+ relapses and 296 E− relapses. The common cold was the most common episode (52%) of E+ relapse, followed by school events (18%). These E+ relapses occurred almost evenly throughout the 4 weeks between each follow-up visit. Conversely, 161 (55%) of the 296 E−z relapses occurred within the 3-day period preceding the patient’s appointment (relapse-related hospital visit, RRHV). McNemar’s test revealed that the concentration of relapses
S. Takahashi (*) : H. Murakami : S. Funaki : K. Harada Department of Pediatrics, Nihon University School of Medicine, 1-8-13 Chiyoda Ward, Kandasurugadai, Tokyo 101-8309, Japan e-mail: shori@med.nihon-u.ac.jp N. Wada Division of Nephrology, Shizuoka Children’s Hospital, 860 Urushiyama, Shizuoka, Shizuoka 420-0953, Japan T. Inagaki Division of General Practice, Miyagi Children’s Hospital, 4-3-17 Ochiai, Aoba Ward, Sendai, Miyagi 989-3126, Japan M. Nagata Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
in this period was statistically significant
ORIGINAL ARTICLE
Triggers of relapse in steroid-dependent and frequently relapsing nephrotic syndrome
Shori Takahashi & Naohiro Wada & Hitohiko Murakami & Satoshi Funaki & Tetsuji Inagaki & Kensuke Harada & Michio Nagata
Received: 3 March 2006 / Revised: 3 August 2006 / Accepted: 17 August 2006 / Published online: 17 October 2006 # IPNA 2006
Abstract An awareness of the triggers of relapse is critical for the control of steroid-dependent, frequently relapsing nephrotic syndrome (SDFRNS). We have investigated the triggers, usually described as ‘episodes’, to such relapses within a temporal context. Thirty-five patients with SDFRNS were analyzed retrospectively. A total of 442 relapses occurred in 2499 patient-months. The relapses were classified into two groups: those with episodes (E+) and those without episodes (E−). There were 135 E+ relapses and 296 E− relapses. The common cold was the most common episode (52%) of E+ relapse, followed by school events (18%). These E+ relapses occurred almost evenly throughout the 4 weeks between each follow-up visit. Conversely, 161 (55%) of the 296 E−z relapses occurred within the 3-day period preceding the patient’s appointment (relapse-related hospital visit, RRHV). McNemar’s test revealed that the concentration of relapses
S. Takahashi (*) : H. Murakami : S. Funaki : K. Harada Department of Pediatrics, Nihon University School of Medicine, 1-8-13 Chiyoda Ward, Kandasurugadai, Tokyo 101-8309, Japan e-mail: shori@med.nihon-u.ac.jp N. Wada Division of Nephrology, Shizuoka Children’s Hospital, 860 Urushiyama, Shizuoka, Shizuoka 420-0953, Japan T. Inagaki Division of General Practice, Miyagi Children’s Hospital, 4-3-17 Ochiai, Aoba Ward, Sendai, Miyagi 989-3126, Japan M. Nagata Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
in this period was statistically significant