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
. 2022 Nov;37(11):2679-2685.
doi: 10.1007/s00467-022-05483-8. Epub 2022 Feb 24.

Rates of idiopathic childhood nephrotic syndrome relapse are lower during the COVID-19 pandemic

Clarkson Crane  1 , Christine Bakhoum  2 , Elizabeth Ingulli  3
Affiliations

Rates of idiopathic childhood nephrotic syndrome relapse are lower during the COVID-19 pandemic

Clarkson Crane et al. Pediatr Nephrol. 2022 Nov.

Abstract

Background: Infections are thought to be primarily responsible for triggering relapse in children with steroid-sensitive nephrotic syndrome (NS). The COVID-19 pandemic promoted physical distancing, facial mask wearing, and greater attention to infection-prevention measures resulting in decreased transmission of infections. We hypothesized there would also be a decreased rate of NS relapse during this period.

Methods: We conducted a single-center retrospective chart review of children with steroid-sensitive NS. Demographics, rate of relapses, and rate of hospitalizations were collected for a baseline pre-pandemic period (BPP) and for the social distancing period during the pandemic (SDP).

Results: One hundred twenty-two children with primary steroid-sensitive NS were identified and 109 were followed for the duration of the study period. The paired rate of relapse per subject per year was significantly lower during the SDP (0.6 relapses per subject per year ± 1 SD) compared to the BPP (1.0 relapses per subject per year ± 0.9 SD), P < 0.01. A subgroup of 32 subjects who were newly diagnosed with NS during the BPP similarly had significantly fewer relapses during the SDP (0.8 ± 1 SD) than during the BPP (1.4 ± 1 SD), P = 0.01.

Conclusions: Our results support the hypothesis of lower rates of NS relapse and hospitalizations during social distancing for all subjects in our cohort and a subgroup of those newly diagnosed. Lower relapse rates were likely attributable to decreased transmission of infections and greater attention to infection prevention. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: COVID-19; Childhood idiopathic nephrotic syndrome; Nephrotic syndrome relapse; Pediatric; Steroid-sensitive nephrotic syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram. Abbreviations: MCD, minimal change disease; FSGS, focal segmental glomerulosclerosis; MN, membranous nephropathy; NS, nephrotic syndrome; SDP, social distancing period; BPP, baseline pre-pandemic period
See this image and copyright information in PMC

References

    1. Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet. 2003;362:629–639. doi: 10.1016/S0140-6736(03)14184-0. - DOI - PubMed
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group (2021) Chapter 4: nephrotic syndrome in children. Kidney Int Suppl 100:163–171. 10.1016/j.kint.2021.05.021
    1. Dossier C, Delbet JD, Boyer O, Daoud P, Mesple B, Pellegrino B, et al. Five-year outcome of children with idiopathic nephrotic syndrome: the NEPHROVIR population-based cohort study. Pediatr Nephrol. 2019;34:671–678. doi: 10.1007/s00467-018-4149-2. - DOI - PubMed
    1. MacDonald NE, Wolfish N, McLaine P, Phipps P, Rossier E. Role of respiratory viruses in exacerbations of primary nephrotic syndrome. J Pediatr. 1986;108:378–382. doi: 10.1016/s0022-3476(86)80876-9. - DOI - PubMed
    1. Uwaezuoke SN. Steroid-sensitive nephrotic syndrome in children: triggers of relapse and evolving hypotheses on pathogenesis. Italian J Pediatr. 2015;41:19. doi: 10.1186/s13052-015-0123-9. - DOI - PMC - PubMed

Publication types

Supplementary concepts