Prevalence of Different Clinical Variants of Nephrotic Syndrome in Children 1–18 Years of Age in Tertiary Care Hospital of North India

  • Koushal Kumar Government Medical College, Jammu, Jammu and Kashmir, India
  • Shalika Sharma Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India
  • Nikhil Gupta Government Medical College, Jammu, Jammu and Kashmir, India
Keywords: Frequent relapsers, Infrequent relapsers, Mycophenolate mofetil, Steroid dependence, Steroid resistance


Introduction: Childhood nephrotic syndrome has an incidence of 90–100 per million population of India. This study was conducted with the primary objective of studying the prevalence of different clinical variants of childhood nephrotic syndrome (new-onset steroid-sensitive nephrotic syndrome/infrequent relapsing nephrotic syndrome [IFRNS]/frequently relapsing nephrotic syndrome [FRNS]/steroid-dependent nephrotic syndrome [SDNS]/steroid-resistant nephrotic syndrome [SRNS]), while the secondary objectives were to estimate the prevalence of use of steroid-sparing drugs in those with FRNS and SDNS.
Materials and Methods: A retrospective study of all patients referred to renal diseases clinic at Government Medical College, Jammu, was done. Records of 61 children of 1–18 years of age fulfilling the International Study of Kidney Disease in Children criteria for nephrotic syndrome attending to our nephrology clinic were reviewed over 1 year period. Standard definitions for new-onset nephrotic syndrome, IFRNS, FRNS, SDNS, and SRNS were used. Steroid-sparing drugs used were levamisole in FRNS and low-dose SDNS whereas cyclophosphamide, mycophenolate mofetil (MMF), and tacrolimus in high-dose SDNS.
Results: Among nephrotic syndrome, patients mean age of presentation was 5.95 years, with M: F ratio of 1.77:1. Infrequent relapsers (27.9%) were the most prevalent clinical variant followed by steroid-dependent nephrotic syndrome (24.6%) and new-onset nephrotic syndrome (21.3%). Prednisolone alone was successful in achieving remission in 50.8% of total cases and less commonly involving use of other immunosuppressants with prednisolone such as levamisole (23%), cyclophosphamide (9.8%), and tacrolimus in (3.3%). However, prednisolone in combination with cyclophosphamide and then MMF was used in 14 (23%) in an aim to achieve full remission, but full remission was achieved in 48 (78.7%).
Conclusion: In the present study, clinical profile of children with nephrotic syndrome was concordant with typical nephrotic syndrome in children. Pattern of nephrotic syndrome differs in our population in terms of increased number with SDNS and response to treatment did not differ significantly from other studies.

Author Biographies

Koushal Kumar, Government Medical College, Jammu, Jammu and Kashmir, India

Lecturer, Department of Pediatrics, 

Shalika Sharma, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India

Associate Professor, Department of Anatomy, 

Nikhil Gupta, Government Medical College, Jammu, Jammu and Kashmir, India

Post Graduate Student, Department of Pediatrics, 


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