The Idiopathic Nephrotic Syndrome of Childhood: A Clinical Reevaluation of 148 Cases

Of 148 children with idiopathic nephrotic syndrome who received corticosteroids, 90 were followed up for five or more years. Sixty-four percent of children were 1 to 5 years old and the male/female ratio was 1.9 to 1. Hypertension, hematuria, and azotemia at onset were noted in 8.2%, 23%, and 7.4%, respectively. Prevalence of significant bacteriuria was 4.7%, antistreptolysin 0 titers were low in 98.4%, serum α₂-globulin levels were elevated in 90%, and a persistently low serum β₁C-globulin level was recorded in 9.3% of children. Younger age at onset, absence of hematuria, hypertension and azotemia, normal β₁C-globulin, and selective proteinuria were signs of favorable prognosis. Three percent of children who initially responded completely became unresponsive in subsequent relapses. After five years, 6.7% have died, 6.7% are in renal failure, 41% are still relapsing, and 45.5% are in remission.