Epidemiology of idiopathic nephrotic syndrome in children: endemic or epidemic?
Epidemiology of idiopathic nephrotic syndrome in children: endemic or epidemic?
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DOI：
10.1007/s00467-016-3509-z
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发表时间：
2016-12-01
影响因子：
3
通讯作者：
Deschenes, Georges
中科院分区：
文献类型：
--
作者：
Dossier, Claire;Lapidus, Nathanael;Deschenes, Georges
特发性肾病综合征（INS）的病因仍部分不明。据报告，病毒感染与INS发作和复发相关。本研究的目的是描述以人群为基础的INS儿童队列的流行病学，并提出一个时空分析。所有年龄在6个月至15岁之间的INS发病于2007年12月至2010年5月，生活在巴黎地区的儿童被纳入一项前瞻性多中心研究。收集了诊断时和2年内的人口统计学和临床特征。188名儿童被诊断为INS，其中93%是类固醇敏感的。年发病率为3.35/10万儿童。8个县中有一个县的标准化发病率（SIR）较高：塞纳-圣但尼，SIR为1.43 [95%置信区间（CI）1.02-1.95]。进一步确定了空间聚类，SIR更高，为1.36（95% CI 1.09-1.67）。在这个高发病率地区的时间分析表明，季节性变化，在冬季期间的高峰（p < 0.01）。此外，将巴黎地区划分为五分之一的人群显示，第一个研究病例的平均发病延迟遵循纵向进展（p < 0.0001），病例的聚集性、该特定地区内的季节变化以及整个巴黎地区的进展，都表明INS可能以流行模式发生。
The etiology of idiopathic nephrotic syndrome (INS) remains partially unknown. Viral infections have been reported to be associated with INS onset and relapse. The aim of this study was to describe the epidemiology of a population-based cohort of children with INS and propose a spatiotemporal analysis.All children aged 6 months to 15 years with INS onset between December 2007 and May 2010 and living in the Paris area were included in a prospective multicenter study. Demographic and clinical features at diagnosis and 2 years were collected.INS was diagnosed in 188 children, 93 % of whom were steroid sensitive. Annual incidence was 3.35/100,000 children. Standardized incidence ratio (SIR) was higher in one of the eight counties: Seine-Saint-Denis, with SIR 1.43 [95 % confidence interval (CI) 1.02-1.95]. A spatial cluster was further identified with higher SIR 1.36 (95 % CI 1.09-1.67). Temporal analysis within this overincidence area showed seasonal variation, with a peak during the winter period (p < 0.01). In addition, partition of the Paris area into quintiles of the population showed that the average delay of occurrence, with regard to the first study case, followed a longitudinal progression (p < 0.0001).The clustering of cases, the seasonal variation within this particular area, and the progression over the Paris area altogether suggest that INS may occur on an epidemic mode.