전국 병원을 대상으로 조사한 소아 특발성 신증후군의 임상적 고찰 - 다기관 공동연구 결과보고 - |
조병수, 강현호 |
1경희대학교 의과대학 소아과학교실 및 대한소아신장학회 2경희대학교 의과대학 소아과학교실 및 대한소아신장학회 |
Primary nephrotic syndrome in children : A nationwide survey in Korea |
Bytung-Soo Cho, Hyeon-Ho Kang |
1Department of Pediatrics, Kyunghee university, College of Medicine, The Korean Society of Pediatric Nephrology 2Department of Pediatrics, Kyunghee university, College of Medicine, The Korean Society of Pediatric Nephrology |
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ABSTRACT |
Purpose: Up to date there is no nationwide survey on epidemiological or clinical data of nephrotic syndrome, so we investigated about age of onset, sex, result of renal biopsy, treatment method, its results of treatment, its responsiveness, time of response to treatment and pattern of relapse in Korea. Methods: Between 1987 and 1997, 2193 patients with primary nephrotic syndrome diagnosed at 38 university hospital and general hospital in Korea were included. Of these 1655 were male and 538 were female. Incidence peaked at 1-5 years of age. Results : Results were as follows; 1) Among 2193 cases, male was 1655($75.5%$), female was 538 cases($24.5%$) and male to female ratio was about 3:1. Among 1752 patients with MCNS, male was 1338, female was 414 and male to female ratio was about 3.23:1. The most prevalent age group was 1-5 years of age. 2) Renal biopsy was done in 942 cases($43%$), pathologic findings were as follows; MCNS 646 cases($68.6%$), FSCS 149 cases($15.8%$). 3) Regimen of treatment were as follows; prednisolone 1191 cases, Calcort 192 cases, cyclophosphamide 251 cases, cyclosporin A 223 cases, MPD pulse therapy 120 cases.4) Complete response to treatment were noted in 1597 cases($82.2%$, n=1944). 5) Responsiveness according to result of renal biopsy were significantly different between MCNS and FSGS. Complete response were noted in $86.5%$ among patients with MCNS, $35.8%$ in patients with FSGS. 6) Time of response to treatment were noted between 1 and 4 weeks after treatment in 879 cases($67.4%$, n=1305). 7) 994 cases($73.1%$) relapsed during follow up, most frequently between 2 months and 6 months after response. Conclusion : Nationwide survey of epidemiological and clinical data were performed in childhood primary nephrotic syndrome. Most of the clinical and epidemiological data were similar to other reports from U.S.A. and from Europe, however male to female ratio is higher in Korean nephrotic syndrome(3:1 in contrast to 2:1). |
Key words:
Primary nephrotic syndrome | Children | Renal biopsy | Korea |
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