Dental Caries in Children Associated with Steroid-Sensitive Nephrotic Syndrome

A recent retrospective study has examined the possible association between steroid-sensitive nephrotic syndrome (SSNS) and dental caries in children, aiming to uncover the role of infection in the pathogenesis and relapse of this medical condition. The research is shedding light on the intriguing connection between oral health and this kidney disorder that primarily affects children.

Comprehensive Cohort Study

The research, conducted over a period from January 2021 to June 2022, involved a cohort of 145 children with SSNS in the baseline analysis, and 105 in the subsequent follow-up study that spanned one year. 

The primary objectives of the study included determining the relapse-free period and the occurrence of frequently relapsing nephrotic syndrome (FRNS). Additionally, the researchers aimed to track the number of relapses, identify potential triggers, and assess medication usage in these young patients.

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Distinct Findings Emerge

The study’s findings revealed several noteworthy statistics within the cohort. The children had a median age of 5.5 years, and a significant caries rate of 60.7%. The mean DMFT/dmft, which is a measure of tooth decay, stood at 3.86, with a caries filling rate of 1.6%. 

While the caries group showed a lower proportion of high household income and parental education, there were no other significant baseline differences observed among the study participants.

The research also found a compelling association between dental caries and the relapse of SSNS. Specifically, the caries group exhibited a shorter relapse-free period and a lower 1-year cumulative relapse-free survival rate. This link was further supported by univariate regression analysis, which revealed an association between caries and frequently relapsing nephrotic syndrome (FRNS). However, it’s important to note that this correlation did not persist in the multivariate analysis, suggesting that other factors might be at play.

Dental Caries as a Trigger

Impact of Pulpectomy vs. Tooth Extraction on Children’s Oral Health

Of particular interest is the observation that seven cases of caries-induced pulpal periapical inflammation were found to have triggered relapses of SSNS in the study. This finding underscores the potential role of oral health conditions in influencing the course of SSNS. 

Moreover, the caries group displayed a higher incidence of infection triggers and concurrent medication usage, highlighting a complex interplay of factors in these patients.

Need for Further Research

While this study provides intriguing insights into the possible connection between dental caries and SSNS relapse in children, the researchers emphasize the need for further investigation. The link between these two health conditions is not yet fully understood, and additional research is warranted to elucidate the underlying mechanisms and potential implications for patient care.

This research opens up new avenues for exploring the complex relationship between oral health and systemic medical conditions, offering hope for improved understanding and management of SSNS in children.

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Source: link.springer.com/article/10.1007/s00467-023-06167-7