Epidemiological and clinical characteristics and evaluation of treatment outcomes with prednisolone in pediatric patients with primary nephrotic syndrome

Abstract

Objective: To evaluate certain epidemiological and clinical characteristics, as well as treatment outcomes of primary nephrotic syndrome in children treated with prednisolone in Hai Phong. Subjects: A total of 45 pediatric patients diagnosed with primary nephrotic syndrome who were monitored and treated as inpatients and outpatients at the General Internal Medicine Department – Hai Phong Children's Hospital from May 1, 2024, to April 30, 2025. Methods: A descriptive study combining retrospective and prospective data collection. Results: The incidence was higher in males than in females with a ratio of 3.5:1 (35 males and 10 females). The mean age of disease onset was 10.8 years, with the 10–16 age group accounting for 64.5% of cases. Children living in rural areas were more affected than those in urban areas, with a rural-to-urban ratio of 3.1:1.4. Edema was present in 100% of cases, while hypertension was observed in 6.7%, oliguria in 2.2%, hematuria in 2.2%, and polyserositis in 17.8%. The mean urinary protein-to-creatinine ratio was 1070 mg/mmol. Hypoalbuminemia was observed with a mean serum albumin level of 22.9 g/L, and hypercholesterolemia with a mean cholesterol level of 9.6 mmol/L. The treatment response rate to corticosteroids was 86.7%, with a mean time to response of 10.4 days. The complete remission rate after 4 weeks of treatment was 86.7%, with 90.3% of these cases classified as the steroid-sensitive (minimal change) subtype. Conclusion: Most pediatric patients with primary nephrotic syndrome were male and of school age. The predominant clinical features were edema, hypoalbuminemia, and marked proteinuria. The disease showed a good response to corticosteroid therapy, with the majority achieving complete remission within 4 weeks.