Childhood Nephrotic Syndrome Treatment Outcome and Associated Factor in Amhara Region Selected Compressive Specialized Hospitals Northwest Ethiopia, Ethiopia, 2024. A Retrospective Follow up Study

Abstract

Background: Childhood nephrotic syndrome is a common glomerular illness in children with a high relapsing rate, which increases complications and the cost of treatment. In Ethiopia, there is limited data to assess the treatment outcome and associated factors nephrotic syndrome. Objectives: To assess treatment outcomes and associated factors in patients with childhood nephrotic syndrome at the University of Gondar Comprehensive and specialized hospital (UOGCSH), Debretabor comprehensive Specialized hospital(DCSH), and Felegehiwot compressive specialized hospitals (FCSH), Northwest Ethiopia, Ethiopia, 2024. Method: An institution-based multicenter retrospective follow-up study was conducted at UOGCSH, DCSH, and FCSHs from April 1, 2020, to May 30, 2024. A convenience sampling technique was used to select study participants. A descriptive analysis was done. Univariable and multivariable logistic regression statistical tests were computed to identify the independent associations and determinants of treatment outcomes. The primary outcome was relapse. The secondary outcome was steroid-related side-effects. P<0.05 was used to declare the association. Result: A total of 399 patients with CNS in the three hospitals were included in this study. The median age of participants at the initial diagnosis was 5 (IQR=4-7years), 215 (53.9%) were males. Most of the patients 362 (90.7%) had complete remission after the initial course of steroid therapy. However, only 166 (41.6%) of children had sustained remission. 233(58.4%) developed relapse. Furthermore, 29 (7.5%) of children develop chronic kidney disease. In children with nephrotic syndrome, male sex (AOR=2.661; P= 0.03), hematuria presence (AOR= 5.404, P value= 0.01), low serum albumin levels (AOR=3.052, P= 0.01), high serum triglyceride (AOR= 5.005, P value= 0.01) and short duration of therapy (AOR= 3.723, P= 0.01) were predictor of relapse. Conclusion: This study revealed that most CNS patients achieved remission with initial steroid therapy. However, there was a higher relapse rate, and relapse-related complications are common. Male sex, haematuria, low serum albumin, high serum triglyceride level and short duration of steroid therapy were independent predictors of relapse.