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Childhood Nephrotic Syndrome Management and Outcome in Metro Atlanta

Wang, Chia-shi (2017)
Master's Thesis (26 pages)
Committee Chair / Thesis Adviser: Greenbaum, Laurence
Committee Members: Klein, Mitchel ; Plantinga, Laura Christine
Research Fields: Medicine
Keywords: nephrotic syndrome; children
Program: Laney Graduate School, Clinical Research Curriculum Program
Permanent url: http://pid.emory.edu/ark:/25593/s37v5

Abstract

There is a paucity of information on outpatient management and risk factors for hospitalization and complications in childhood nephrotic syndrome (NS). We described the management, patient adherence, inpatient and outpatient usage, and disease complications of 87 pediatric NS patients diagnosed between 2006 and 2012 in the Atlanta MSA. Multivariable analyses were performed to examine the associations between patient characteristics and disease outcome. On average, patients had 3.7 (2.0) clinic visits per year. Fifty-one percent of the patients were treated with two or more immunosuppressants. Approximately half of the patients were noted to be non-adherent with medications and urine protein monitoring. The majority (71%) of patients were hospitalized at least once, with a median rate of 0.5 hospitalizations per patient year. Mean hospital length of stay was 4.0 (3.8) days. Fourteen percent of patients experienced at least one serious disease complication. Black race, frequently-relapsing/steroid-dependent and steroid-resistant disease, and the first year following diagnosis were associated with higher hospitalization rates. The presence of co-morbidities was associated with longer hospital length of stay and increased risk of serious disease complications. Our results highlight the high morbidity and burden of NS and point to particular patient subgroups that may be at increased risk for poor outcome.

Table of Contents

INTRODUCTION.......................................................................................................2

BACKGROUND...........................................................................................................3

METHODS…………………………………………………………………………………………….…………………………………..…6

RESULTS……………………………………………………………………………………………………………………………………11

DISCUSSION……………………………………………………………………………………………………..………………………14

REFERENCES………………………………………………………………………………………………..……………………………17

TABLES/FIGURES………………………………………………………………………………………..……………….……………18

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