Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome

被引：97

作者：

Banh, Tonny H. M. ^{[1
]}

Hussain-Shamsy, Neesha ^{[1
]}

Patel, Viral ^{[1
]}

Vasilevska-Ristovska, Jovanka ^{[1
]}

Borges, Karlota ^{[1
]}

Sibbald, Cathryn ^{[1
]}

Lipszyc, Deborah ^{[1
]}

Brooke, Josefina ^{[2
]}

Geary, Denis ^{[2
,4
]}

Langlois, Valerie ^{[2
,4
]}

Reddon, Michele ^{[2
]}

Pearl, Rachel ^{[2
,4
]}

Levin, Leo ^{[2
,4
]}

Piekut, Monica ^{[2
]}

Licht, Christoph P. B. ^{[2
,3
,4
]}

Radhakrishnan, Seetha ^{[2
,4
]}

Aitken-Menezes, Kimberly ^{[2
]}

Harvey, Elizabeth ^{[2
,4
]}

Hebert, Diane ^{[2
,4
]}

Piscione, Tino D. ^{[2
,4
]}

Parekh, Rulan S. ^{[1
,2
,4
,5
,6
]}

机构：

[1] Hosp Sick Children, Res Inst, Child Hlth Evaluat Sci, Toronto, ON, Canada

[2] Hosp Sick Children, Div Nephrol, Toronto, ON, Canada

[3] Hosp Sick Children, Cell Biol Program, Res Inst, Toronto, ON, Canada

[4] Univ Toronto, Toronto, ON, Canada

[5] Univ Hlth Network, Toronto, ON, Canada

[6] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2016年 / 11卷 / 10期

关键词：

FOCAL SEGMENTAL GLOMERULOSCLEROSIS; STEROID-RESISTANT; RENAL-DISEASE; RISK; CHILDREN; CYCLOPHOSPHAMIDE; RACE; PROGRESSION; VALIDATION; MANAGEMENT;

D O I：

10.2215/CJN.00380116

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background and objectives Ethnic differences in outcomes among children with nephrotic syndrome are unknown. Design, setting, participants, & measurements We conducted a longitudinal study at a single regional pediatric center comparing ethnic differences in incidence from 2001 to 2011 census data and longitudinal outcomes, including relapse rates, time to first relapse, frequently relapsing disease, and use of cyclophosphamide. Among 711 children, 24% were European, 33% were South Asian, 10% were East/Southeast Asian, and 33% were of other origins. Results Over 10 years, the overall incidence increased from 1.99/100,000 to 4.71/100,000 among children ages 1-18 years old. In 2011, South Asians had a higher incidence rate ratio of 6.61 95% confidence interval, 3.16 to 15.1) compared with Europeans. East/Southeast Asians had a similar incidence rate ratio 0.76; 95% confidence interval, 0.13 to 2.94) to Europeans. We determined outcomes in 455 children from the three largest ethnic groups with steroid-sensitive disease over a median of 4 years. South Asian and East/Southeast Asian children had significantly lower odds of frequently relapsing disease at 12 months South Asian: adjusted odds ratio; 0.55; 95% confidence interval, 0.39 to 0.77; East/Southeast Asian: adjusted odds ratio; 0.42; 95% confidence interval, 0.34 to 0.51), fewer subsequent relapses South Asian: adjusted odds ratio; 0.64; 95% confidence interval, 0.50 to 0.81; East/Southeast Asian: adjusted odds ratio; 0.47; 95% confidence interval, 0.24 to 0.91), lower risk of a first relapse South Asian: adjusted hazard ratio, 0.74; 95% confidence interval, 0.67 to 0.83; East/Southeast Asian: adjusted hazard ratio, 0.65; 95% CI, 0.63 to 0.68), and lower use of cyclophosphamide South Asian: adjusted hazard ratio, 0.82; 95% confidence interval, 0.53 to 1.28; East/Southeast Asian: adjusted hazard ratio, 0.54; 95% confidence interval, 0.41 to 0.71) compared with European children. Conclusions Despite the higher incidence among South Asians, South and East/Southeast Asian children have significantly less complicated clinical outcomes compared with Europeans.

引用

页码：1760 / 1768

页数：9

共 44 条

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