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Nephrotic Syndrome (NS) is defined as increased glomerular permeability caused by damaged renal basement membrane which causes hypoalbuminemia and proteinuria. In many cases, persistent injury may lead to permanent scarring and persistent symptoms. Current epidemiological data presented a high number of relapses and failed remissions of NS. Assessment of NS patients could help identify key points on selecting the appropriate choice of immunosuppressive therapy. Hence, this study was conducted to present NS characteristics and answer the following question: How does a remission in nephrotic syndrome unfold through a 30 days evaluation after receiving immunosuppressive therapy?
Study Design and Participants
Data was collected retrospectively from January to September 2023 at K.R.M.T. Wongsonegoro Regional Hospital Semarang, Indonesia. All patients with NS in this study were diagnosed based on Kidney Disease: Improving Global Outcomes (KDIGO) 2021 guidelines, using Antinuclear Antibody (ANA) Test from blood sample and/or histopathologic sample obtained from kidney biopsy. Patients with a positive ANA test and/or histopathologic sample alongside clinical findings compatible with NS were included in this study. Immunosuppressive and supportive therapy were given to each patient.
Data Collection and Analysis
Authors worked independently to review and extract the following data from electronic medical records: demographic characteristics, medical history, clinical findings, laboratory findings, histopathology results and therapy. Main outcome assessed in this study are patient’s clinical outcome after receiving therapy for 30 days. Clinical findings and laboratory analysis were observed and carried out just before kidney biopsy was performed and on the day evaluation was conducted (30 days after treatment was given).
There are 13 patients with NS included in this study. Their average age was 27.9 (SD 11.7) with a median of 24 years. There were eight patients and five patients who experienced single and multiple NS, respectively. Lupus nephritis was the most common diagnosis recorded in this study. The most common manifestations were peripheral edema (84.6%) and periorbital edema (30.7%). The majority of the histologic patterns showed a mesangial proliferation (46.1%) and inflammatory cells infiltration (30.7%) which shows the ongoing local injury in some of the glomeruli.
Table 1. Patients Characteristics
There are 13 patients with nephrotic syndrome included in this study. All patients experienced resolution of symptoms. Four paix patients had partial remission and one patient had complete remission of nephrotic syndrome after receiving immunosuppressive therapy for 30 days.