Background: Steroid Sensitive Nephrotic Syndrome (SSNS) follows a relapsing and remitting course in many of the cases. Time for initial response to corticosteroids has been identified as a prognostic factor in idiopathic nephrotic syndrome.
Objectives: To determine the time to initial remission as well as the pattern of relapses among children with SSNS in Umuahia South East Nigeria.
Methods: Records of children with SSNS from July 2013 to June 2018 were reviewed for responses to corticosteroid and relapses in their first year.
Results: Twenty-four children with Idiopathic Nephrotic syndrome were followed up for one year. Male to female ratio was 3:1 of which fifteen (62.5%) responded to steroid and they were aged 2 to 9 years. Median time to remission was 14 days. Of the 15 steroid responsive patients, 11 (73.3%) were early responders while 4 (26.7%) were late responders. Six patients had at least one episode of relapse giving a relapse rate of 40.0%. Of these six, four (66.7%) were infrequent relapsers while 2 (33.3%) were frequent relapsers. Relapse rate was not significantly different across age groups (p = 0.622) and gender (p = 0.294). Presence of hypertension, haematuria and delayed time to remission did not significantly influence relapse. Acute respiratory infection was the most frequent trigger of relapse.
Conclusion: More than two-thirds of children with NS in our centre experience early steroid response while less than one-third respond after 4 weeks of therapy. Less than half of the children experience a relapse in the first year of follow up.