Review on long-term non-renal complications of childhood nephrotic syndrome

Acta Paediatr. 2020 Mar;109(3):460-470. doi: 10.1111/apa.15035. Epub 2019 Oct 22.

Abstract

Background: Nephrotic syndrome (NS) is the most common glomerular childhood disease. A body of literature has described the long-term renal prognosis of childhood-onset idiopathic NS. However, the nonrenal outcomes have not been studied as much.

Aim: We aimed to discuss the long-term non-renal outcomes of childhood NS, highlighting studies with a follow-up period of more than 10 years.

Results: We reviewed the literature and found that a number of immunosuppressive agents have stopped inflammation, stabilised the podocyte cytoskeleton and reduce proteinuria. However, prolonged treatment has frequently been associated with a high risk of renal and non-renal complications in patients with a complicated disease course, defined as frequent relapses or steroid dependency. Non-renal complications may include impaired longitudinal growth and pubertal development, undesirable fertility outcomes, ocular complications, bone mineral diseases and potential malignancies.

Conclusion: This review discusses and summarises the non-renal outcomes of idiopathic childhood NS.

Keywords: long-term; morbidity; nephrotic syndrome; non-renal complications; prognosis; quality of life.

Publication types

  • Review

MeSH terms

  • Humans
  • Immunosuppressive Agents
  • Kidney
  • Nephrotic Syndrome* / complications
  • Proteinuria
  • Recurrence

Substances

  • Immunosuppressive Agents