Steroid response and outcomes in childhood nephrotic syndrome: A multicenter, cross-sectional study from Jordan

Table 1 Baseline demographics and characteristics of children with childhood idiopathic nephrotic syndrome

Characteristic	Frequency (n = 122)	Percentage (%)
Male	78	63.9
Female	44	36.1
Center
Karak	44	36.1
Al Basheer	62	50.8
Jordan University	16	13.1
Positive family history	19	15.6
Underwent biopsy	57	46.7
Underwent genetic testing	6	4.9
Age at diagnosis, years (median)	4 (1–14)
Follow-up time, years (median)	2 (1–15)
Time to first relapse, months (median)	9 (2–18)
Median number of relapses per year median)	2.6 ± 1.7
Median time of steroid-sparing use (years)	2 (1–4)
Median age of the cohort at data entry (years)	8 (2–18)
Premature	4	3.3
Birth weight < 2.5 kg	10	8.2
Clinical course and outcomes
Type of nephrotic syndrome
SSNS	53	43.4
SRNS	23	18.9
SDNS	35	28.7
FRNS	11	9.0
Use of steroid-sparing medications	51	41.8
Microscopic hematuria	36	29.5
Hypertension	22	18.0
Nephrotic syndrome complications	49	40.2
CKD and ESKD	9	7.4
Dialysis	8	6.6
Transplant	4	3.3
Death	4	3.3
Significant steroid side effects	21	17.2
Type of steroid side effects (n = 21)
Bone and leg pain	7	33.3
Aggression	7	33.3
Hypertension	1	4.8
Obesity	6	28.6

CKD: Chronic kidney disease; ESKD: End-stage kidney disease; SSNS: Steroid-sensitive nephrotic syndrome; SRNS: Steroid-resistant nephrotic syndrome; SDNS: Steroid dependent nephrotic syndrome; FRNS: Frequently relapsing nephrotic syndrome.

Table 2 Type of nephrotic syndrome across the age groups of the cohort, n (%)

Current age group, years	Type of NS				Total
	SSNS	SRNS	SDNS	FRNS
1–3	2 (40)	1 (20)	1 (20)	1 (20)	5 (100)
3–6	19 (59)	4 (12.5)	7 (21.8)	2 (6.3)	32 (100)
6–12	29 (44.6)	11 (16.9)	20 (30.7)	5 (7.7)	65 (100)
12–15	3 (23)	6 (46.1)	3 (23.1)	1 (7.7)	13 (100)
> 15	0	1 (14.2)	4 (57.1)	2 (28.6)	7 (100)
	53 (43.4)	23 (18.9)	35 (28.7)	11 (9)	n = 122

P = 0.102. SSNS: Steroid-sensitive nephrotic syndrome; SRNS: Steroid-resistant nephrotic syndrome; SDNS: Steroid-dependent nephrotic syndrome; FRNS: Frequently relapsing nephrotic syndrome; NS: Nephrotic syndrome.

Table 3 Kidney biopsy histopathological findings

Histopathological finding	Frequency, n = 57	Percentage (46.7%)
MCD	32	56.1
FSGS	19	33.3
DMS	1	1.8
Membranous	1	1.8
mesPGN	4	7

FSGS: Focal segmental glomerulosclerosis; MCD: Minimal change disease; mesPGN: Mesangio-proliferative glomerulonephritis; DMS: Diffuse mesangial sclerosis.

Table 4 Steroid-sparing medications, n (%)

Medication	Patients received steroid-sparing medications, n = 51
Cyclosporine	26 (51.0)
Tacrolimus	1 (2.0)
Mycophenolate	20 (39.2)
Cyclophosphamide	1 (2.0)
Levamisole	3 (5.9)