Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome
Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome
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DOI：
10.2215/cjn.00380116
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发表时间：
2016-10-01
影响因子：
9.8
通讯作者：
Parekh, Rulan S.
中科院分区：
文献类型：
--
作者：
Banh, Tonny H. M.;Hussain-Shamsy, Neesha;Parekh, Rulan S.
背景和目的肾病综合征患儿预后的种族差异尚不清楚。设计、设置、参与者和测量我们在一个地区儿科中心进行了一项纵向研究，比较2001年至2011年人口普查数据和纵向预后的种族差异，包括复发率、首次复发时间、频繁复发疾病和环磷酰胺的使用。在711名儿童中，24%是欧洲人，33%是南亚人，10%是东亚/东南亚人，33%是其他origin.Results超过10年，总发病率从1.99/10万上升到4.71/10万1-18岁的儿童。2011年，与欧洲人相比，南亚人的发病率比为6.61（95%置信区间，3.16 - 15.1）。东亚/东南亚人与欧洲人的发病率相似（比值0.76; 95%置信区间0.13 - 2.94）。我们确定了来自三个最大种族的455名类固醇敏感性疾病儿童的结果，中位数为4年。南亚和东亚/东南亚儿童在12个月时频繁复发疾病的几率显著较低（南亚：调整后的比值比; 0.55; 95%置信区间，0.39至0.77;东亚/东南亚：调整后的比值比; 0.42; 95%置信区间，0.34至0.51），后续复发较少南亚：调整后的比值比; 0.64; 95%置信区间，0.50 - 0.81;东亚/东南亚：校正的比值比; 0.47; 95%置信区间，0.24 - 0.91），首次复发风险较低南亚：校正的风险比，0.74; 95%置信区间，0.67 - 0.83;东亚/东南亚：校正的风险比，0.65;南亚：校正的风险比，0.82; 95%置信区间，0.53 - 1.28;东亚/东南亚：校正的风险比，0.54; 95%置信区间，0.41至0.71）与欧洲儿童相比。结论尽管南亚人的发病率较高，与欧洲儿童相比，南亚和东亚/东南亚儿童的临床结果明显不那么复杂。
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.