Mehtap Çelakıl, Pınar Dervişoğlu, Merve Aktaş Özgür, Kenan Bek
Eurasian Clinical and Analytical Medicine - 2026;14(1):15-19
Aim: Idiopathic nephrotic syndrome is the most common primary glomerular disease in children. The optimal therapeutic regimen for managing children at the onset and during idiopathic nephrotic syndrome is still under debate. Materials and Methods: A 10-year retrospective review of 185 children with idiopathic nephrotic syndrome at the University hospital identified 125 eligible patients. At the last follow-up, they were classified as steroid-dependent, steroid-resistant, or in remission. Results: Steroid-resistant nephrotic syndrome was observed in 27 patients (21.6%) and steroid-dependent nephrotic syndrome in 34 patients (27.2%). Male predominance (M/F: 1.9) was consistent with the literature. Only 9 patients (7.2%) had no relapse after the first episode, while 64 patients remained in remission at the last follow-up. Sixty patients (48%) received at least one immunosuppressive agent other than steroids. Frequent relapses and steroid resistance were significantly more common in patients with obesity at diagnosis. Low albumin level at diagnosis, time to first remission, immunosuppressive drug use, pulse steroid requirement, hypertension, and macroscopic hematuria were significant prognostic factors for renal survival in patients in remission. The prognostic albumin cut-off value was 1.8 g / dL. Discussion: Although it is hard to withdraw robust conclusions from our results, it might be thought that children with obesity, hypoalbuminemia (< 1.8 g / dL), and female gender seem to deserve closer follow-up and somewhat more aggressive management in idiopathic nephrotic syndrome in terms of renal survival.
