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Nephrotic Syndrome

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The Prognosis of Nephrotic Syndrome

2013-09-21 16:35| Font Size A A A

The prognosis of nephrotic syndrome varies with etiology, pathology type, and treatment. In assessing the prognosis of nephrotic syndrome, the following factors can be used as a reference:

(1) Age: Among the children with primary nephrotic syndrome, minimal change nephropathy (MCD) account for around 80%. MCD in 2 to 6 years old age group reach to 85%. It gradually decreased with age. In adult over the age of 30 only accounted for 20%. This type of nephrotic syndrome with favorable prognosis, so 54% of children can complete response, only 21% of adults can alleviate completely. But in children, the smaller the onset age, the higher the fatality rate. However, also some people hold different views. A statistics from UK show that about 15% of children with nephrotic syndrome continued to have symptoms when they grow up.

(2) Hematuria: the hematuria of nephrotic syndrome type 1 is not obvious. Its pathologies mostly are MCD or mild MPGSN with favorable prognosis. Obvious hematuria Ⅱ belong to nephrotic syndrome type with a poor prognosis.

(3) Proteinuria: selective proteinuria shows light lesions with favorable prognosis. Whereas, Non-selective proteinuria with poor prognosis. In early stage, if proteinuria severe, then the renal failure appears earlier, the prognosis is poor.

(4) Hypertension and Azotemia: It common in nephrotic syndrome type Ⅱ, is not sensitive to hormone therapy and its prognosis is poor.

(5) Serum cholesterol: Serum cholesterol decrease always found in MCD. Secondary nephrotic syndrome caused by systemic lupus erythematosus shows normal serum cholesterol. Thus, it sees the serum cholesterol increased patients with favorable prognosis. For children, if serum cholesterol higher than 20.8 mmol/L, fatality rate is very high.

(6) Onset to Start of Treatment (OTT): With early diagnosis and treatment, the prognosis is relatively favorable. If nephrotic syndrome has appearenced over 6 months, the prognosis of treatment with corticosteroids is poor. There are only 15% of cases of complete or partial response under this condition.

(7) The time of edema appearance: There is statistics show that nephrotic syndrome happened the largest number of renal failure in 3-4 years after the first appeared edema.

(8) Response to the hormone: If nephritic syndrome patients had a bad respond to corticosteroids signals it is difficult to treat, and with poor prognosis.

The Prognosis of Interstitial Nephritis

The disease prognosis of chronic interstitial nephritis vary with the cause and degree of kidney damage. If the cause be rid completely, chronic interstitial nephritis could be cured. If already developed to the stage of chronic renal insufficiency, it might cause chronic renal failure and poor prognosis.

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