STEROID-RESPONSE PATTERN IN INDIAN CHILDREN WITH NEPHROTIC SYNDROME

The steroid response pattern to standard prednisolone therapy is of im mense diagnostic, therapeutic and prognostic value for the treating ph ysician in managing children with nephrotic syndrome. None of the stud ies from our country has analysed the clinical, biochemical and histop athological profile in different steroid response categories. To addre ss this problem we conducted a study comprising 127 children with neph rotic syndrome referred to our Institute. They were treated with oral prednisolone according to the APN protocol. Based on the subsequent re sponse these children were classified into different steroid response categories on follow-up. Of the 116 children with follow-up of more th an six months, infrequent relapsers constituted the majority (37.9%). The frequency of other steroid response categories was as follows: fre quent relapsers (21.6%), steroid-dependent (18.1%), initial nonrespond ers (17.3%) and subsequent non-responders (5.1%). The factors predicti ng a poor response to standard prednisolone therapy in our study were age of onset more than eight years, male sex, hypertension, microscopi c haematuria and presence of non-minimal change nephrotic syndrome les ions on histopathology.