Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct 7;11(10):1760-1768.
doi: 10.2215/CJN.00380116. Epub 2016 Jul 21.

Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome

Tonny H M Banh  1 , Neesha Hussain-Shamsy  1 , Viral Patel  1 , Jovanka Vasilevska-Ristovska  1 , Karlota Borges  1 , Cathryn Sibbald  1 , Deborah Lipszyc  1 , Josefina Brooke  2 , Denis Geary  2   3 , Valerie Langlois  2   3 , Michele Reddon  2 , Rachel Pearl  2   3 , Leo Levin  2   3 , Monica Piekut  2 , Christoph P B Licht  2   4   3 , Seetha Radhakrishnan  2   3 , Kimberly Aitken-Menezes  2 , Elizabeth Harvey  2   3 , Diane Hebert  2   3 , Tino D Piscione  2   3 , Rulan S Parekh  1   2   3   5   6
Affiliations

Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome

Tonny H M Banh et al. Clin J Am Soc Nephrol. .

Abstract

Background and objectives: Ethnic differences in outcomes among children with nephrotic syndrome are unknown.

Design, setting, participants, & measurements: We conducted a longitudinal study at a single regional pediatric center comparing ethnic differences in incidence from 2001 to 2011 census data and longitudinal outcomes, including relapse rates, time to first relapse, frequently relapsing disease, and use of cyclophosphamide. Among 711 children, 24% were European, 33% were South Asian, 10% were East/Southeast Asian, and 33% were of other origins.

Results: Over 10 years, the overall incidence increased from 1.99/100,000 to 4.71/100,000 among children ages 1-18 years old. In 2011, South Asians had a higher incidence rate ratio of 6.61 (95% confidence interval, 3.16 to 15.1) compared with Europeans. East/Southeast Asians had a similar incidence rate ratio (0.76; 95% confidence interval, 0.13 to 2.94) to Europeans. We determined outcomes in 455 children from the three largest ethnic groups with steroid-sensitive disease over a median of 4 years. South Asian and East/Southeast Asian children had significantly lower odds of frequently relapsing disease at 12 months (South Asian: adjusted odds ratio; 0.55; 95% confidence interval, 0.39 to 0.77; East/Southeast Asian: adjusted odds ratio; 0.42; 95% confidence interval, 0.34 to 0.51), fewer subsequent relapses (South Asian: adjusted odds ratio; 0.64; 95% confidence interval, 0.50 to 0.81; East/Southeast Asian: adjusted odds ratio; 0.47; 95% confidence interval, 0.24 to 0.91), lower risk of a first relapse (South Asian: adjusted hazard ratio, 0.74; 95% confidence interval, 0.67 to 0.83; East/Southeast Asian: adjusted hazard ratio, 0.65; 95% CI, 0.63 to 0.68), and lower use of cyclophosphamide (South Asian: adjusted hazard ratio, 0.82; 95% confidence interval, 0.53 to 1.28; East/Southeast Asian: adjusted hazard ratio, 0.54; 95% confidence interval, 0.41 to 0.71) compared with European children.

Conclusions: Despite the higher incidence among South Asians, South and East/Southeast Asian children have significantly less complicated clinical outcomes compared with Europeans.

Keywords: Asian Continental Ancestry Group; Ethnic Groups; European Continental Ancestry Group; Humans; Incidence; Longitudinal Studies; Recurrence; children; cyclophosphamide; ethnicity; nephrotic syndrome; steroids.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Proportion of frequently relapsing nephrotic syndrome and absolute number of relapses by ethnicity among 455 children with nephrotic syndrome (1993–2014). (A) Data by ethnicity shows frequently relapsing nephrotic syndrome at 6, 12, and 18 months from diagnosis. (B) Absolute total number of relapses by ethnicity. (C) Absolute number of relapses after treatment with cyclophosphamide. *P value ≤0.05; ***P value ≤0.001.
Figure 2.
Figure 2.
Kaplan–Meier cumulative probability curves for time to first relapse and time to cyclophosphamide by ethnicity. (A) Developing first relapse from diagnosis of nephrotic syndrome in days. (B) Use of cyclophosphamide from diagnosis of nephrotic syndrome in years.
See this image and copyright information in PMC

References

    1. Eddy AA, Symons JM: Nephrotic syndrome in childhood. Lancet 362: 629–639, 2003 - PubMed
    1. McKinney PA, Feltbower RG, Brocklebank JT, Fitzpatrick MM: Time trends and ethnic patterns of childhood nephrotic syndrome in Yorkshire, UK. Pediatr Nephrol 16: 1040–1044, 2001 - PubMed
    1. Seedat YK: Nephrotic syndrome in the Africans and Indians of South Africa. A ten-year study. Trans R Soc Trop Med Hyg 72: 506–512, 1978 - PubMed
    1. Wong W: Idiopathic nephrotic syndrome in New Zealand children, demographic, clinical features, initial management and outcome after twelve-month follow-up: Results of a three-year national surveillance study. J Paediatr Child Health 43: 337–341, 2007 - PubMed
    1. Greenbaum LA, Benndorf R, Smoyer WE: Childhood nephrotic syndrome--current and future therapies. Nat Rev Nephrol 8: 445–458, 2012 - PubMed

Publication types

MeSH terms