Analysis Of Clinical Features And Relapse Factors Of Primary Nephrotic Syndrome In Children

Objective: To summarize and analyze the clinical and laboratory data of primary nephrotic syndrome(PNS)patients diagnosed for the first time,and to explore the clinical characteristics and relapse factors.Methods: The subjects of this study were children with initial nephrotic syndrome who were diagnosed in the Department of Renal and rheumatic Immunity of Pediatric Internal Medicine,the Second Hospital of Hebei Medical University from January 2017 to December 2021.Clinical data,laboratory examination data after admission and follow-up of PNS children were collected.The clinical features of 265 cases of primary nephrotic syndrome in newly diagnosed children were summarized and the relapsing factors were analyzed.Results: A total of 265 cases were included in this study,including 192boys(72.45%)and 73 girls(27.55%),with a male to female ratio of 2.63:1.Most children with PNS are boys.The mean age of onset of PNS was6.02±3.57 years old,the minimum age of onset was 0.67 years old,and the maximum age was 14.33 years old.There were 2 cases(0.75%)in infancy,71cases(26.79%)in infancy,99 cases(37.36%)in pre-school age,68 cases(25.66%)in school age,25 cases(9.43%)in adolescence.The peak age of PNS children was early school age.All 265 children with PNS were diagnosed with hypoalbuminemia and hyperlipidemia.Plasma albumin level was 15.97±4.64g/L.Total cholesterol level: 10.09±2.48mmol/L;Ig E levels were detected in 47 children with PNS,of which 29(61.70%)had increased to varying degrees.Ig G was detected in265 children with PNS,and the level of Ig G was decreased in 256(96.60%)children.When diagnosed with PNS,the qualitative quality of urinary protein was mainly 3+ ～ 4+(88.30%),and the median quantitative value of urinary protein at 24 h was 2.47 g / 24h(interquartile interval 2.34 g / 24h).Urine protein conversion time was 9 days,male and female urine protein conversion time was 9 days.93.58% of the children turned negative within 4 weeks,3.77%of the children turned negative from 4 to 8 weeks,and 2.64% of the children did not turn negative after 8 weeks.Among 265 newly diagnosed children with PNS,104 had relapse,including 76 boys(73.08%)and 28 girls(26.92%).There were 161 children without recurrence,including 116 boys(72.05%)and 45 girls(27.95%).There was no significant difference in gender between the two groups(P>0.05).In the relapse group,90 cases(86.54%)were infected and 14 cases(23.46%)were not infected at the first diagnosis.In the group without recurrence,128cases(79.50%)were infected and 33 cases(20.50%)were not infected at the first diagnosis.There was no significant difference in clinical classification between the two groups(P > 0.05).In the recurrence group,34 cases(22.82%)were nephritis type and 115 cases(77.18%)were simple type.In the group without recurrence,there were 23 cases(19.83%)of nephritis type and 93cases(80.17%)of simple type.Compared with the two groups,there was a significant difference in clinical classification between the no recurrence group and the recurrence group(P<0.05).Conclusions: The onset age of newly diagnosed PNS children peaked in early school age,and most of them were boys.Simple type is the most common clinical classification of PNS children.The recurrence of PNS in children was significantly different from the clinical type,and the nephritis type was more likely to relapse than the simple type.There was no significant difference in the recurrence of PNS in children with gender and whether they were co-infected at the first onset.