Relationship between time to clinical remission and relapse in adults with steroid-sensitive minimal change disease: a retrospective cohort study

Abstract

Objective Minimal change disease (MCD) is a common nephrotic syndrome that is usually steroid-sensitive and has high relapse rate. The aim of this study was to investigate the relationship between time to clinical remission and recurrence after the initial steroid therapy.Methods Among 305 adult patients diagnosed with MCD via light and electron microscopy, sensitive to steroids, and hospitalized for nephrotic syndrome in the Department of Nephrology of the Affiliated Hospital of Guangdong Medical University in China, 88 were included in this retrospective cohort study. Cox regression analysis was performed with time to clinical remission and 24-hour urine protein quantification (24 hUTP), absolute basophil (BA) and basophil percentage (BA%) as independent variables. Independent variables with significant differences and the time to remission were used to construct a Cox regression model to exclude the influence of confounding factors. The receiver operating characteristic (ROC) curve was plotted according to the independent variable of time to clinical remission.Results No significant differences were found between the relapse and non-relapse groups in terms of sex, age at onset, or prevalent hypertension. There were significant differences in time to clinical remission, 24 hUTP, BA and BA% between the relapse and non-relapse groups. The risk of recurrence was significantly higher in patients with clinical remission of 15–21, 22–28 and 29–56 days than in those who had clinical remission of 1–7 days. In addition, patients with clinical remission of >26.5 days had a significantly higher risk of recurrence than those in the other groups.Conclusions Overall, the time of clinical remission is a potential factor for predicting the recurrence of steroid-sensitive MCD in adults.

Keywords

• Minimal change disease
• steroid sensitive
• urine protein
• relapse