Clinical, Pathologic And Prognostic Analysis In Children With Steroid-resistant Nephritic Syndrome

Objective To study the feature of clinic, pathology and prognosis inchildren with steroid-resistant nephritic syndrome(SRNS).Methods Children with SRNS hospitalized in Division ofNephrology and Immunology of our hospital from January2003toDecember2012were analyzed retrospectively in clinic, pathology andprognosis.Results162patients were investigated,which accounted for10.8%of children with Primary nephritic syndrome(PNS),and the mean age ofonset was6.9±3.8years.（1）Renal biopsy was performed in132patients,of them60showed mesangial proliferative glomerulonephritis（MsPGN），30showed focal segmental glomerulosclerosis(FSGS)，19showed minimalchange disease(MCD)，8showed membranoproliferativeglomerulonephritis (MPGN)，5showed membranous nephropathy (MN),1showed proliferative sclerosis glomerulonephritis (PSGN). Patients with non minimal change disease (non-MCD) had a signifinant prevalence ofhematuria. The distribution of pathologic type between age groups andclinical classification was signifinantly different respectively (P<0.05).（2）132patients were followed up,of them58was in complete remission,26was in partial remission,15was not in remission,8was dead, and themean time for complete remission was15months（3～84）.Prognosiscorrelated with pathologic type（P<0.01）。Conclusion （1）There was a preponderance of non-MCD in childrenwith SRNS，and with MsPGN and FSGS being the major pathologic type.Hematuria was a predictor of glucocorticoid resistance.（2）Children withSRNS had a long time proteinuria and poor prognosis. FSGS had a poorprognosis compared to those with MsPGN.