PROLONGED DURATION OF NEPHROTIC SYNRDROM AND TREATMENT FAILURE AMONG CHILDREN WITH NEPHROTIC SYNDROME IS ASSOCIATED WITH INCREASED HYPERTENSION.

Abstract

Background; Nephrotic syndrome (NS) is one of the most common renal diseases found in the paediatric population and is associated with significant complications, including infection and thrombosis. A high proportion of children enter sustained remission before adulthood, and therapy must therefore mitigate the childhood complications, while minimising the long-term risk to health. Objective; To determine the frequency of hypertension in children with nephrotic syndrome presenting at a tertiary care hospital. Material and Methods; All the patients (n = 146) who meet inclusion of this study were registered from OPD of Department of Pediatrics, Nishtar Hospital, Multan, Pakistan. Informed consent was taken from the parents of these children describing them objectives of this study, ensuring them confidentiality of the information provided and fact that there was no risk involved to the patient while taking part in this study. Children with steroid sensitive nephrotic syndrome were taken in this study. Systolic and diastolic blood pressure was measured by researcher. Results; Of these 146 study cases, 92 (63%) were male patients while 54 (37 %) were female patients. Mean age of our study cases was 7.61 ± 2.55 years. Our study results have indicated that majority of our study cases i.e. 91 (62.3 %) were aged more than 7 years. Of these 146 study cases, 76 (52.1 %) belonged to rural areas and 70 (47.9 %) belonged to urban areas. Positive family history was noted in 11 (7.5%) and 129 (88.4%) mothers of these patients were illiterate. Compliance with the treatment was noted only in 31 (21.2%) of our study cases. Mean disease duration was 18.51 ± 10.26 months and 86 (58.9%) had duration of illness more than 12 months. Mean duration of treatment was 6.58± 2.28 months and 113 (77.4%) were taking their treatment for equal/less than 1 year. Mean systolic blood pressure was 135.85 ± 5.12 mmHg while diastolic blood pressure was 90.87 ± 3.25 mmHg. Hypertension was noted in 54 (37%) of our study cases. Conclusion; Frequency of hypertension was high among children having nephrotic syndrome in our study. Hypertension was significantly associated with family history, treatment compliance and prolonged disease duration. All clinicians treating such patients should monitor such children for hypertension for timely diagnosis and early management which will improve clinical outcomes and decrease disease morbidity. This will help to improve quality of life of our patients and also save them from future hardships.

Keywords; Hypertension, Nephrotic Syndrome, Frequency.