Nephro-Urol Mon. 2020 November; 12(4):e106995. Published online 2020 October 19. doi: 10.5812/numonthly.106995. Research Article Steroid Response Pattern Among Children with Nephrotic Syndrome in Northern Ethiopia Elizabeth Akitsa Imbusi 1, * , Peter Etim Ekanem 2 , Hailemariam Gebrearegay 1 , Misikir Ambaye 1 , Afewerki Tesfahunegn 3 , Kendi Nyaga 1 , Regina Ekanem 4 and Nissi Peter 5 1 Department of Pediatrics and Child Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia 2 Department of Anatomy, College of Health Sciences, MekelleUniversity, Mekelle, Ethiopia 3 Department of Epidemiology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia 4 College of Health Sciences, Mekelle University, Mekelle, Ethiopia 5 Houston Community College, Stafford Campus, Texas, USA * Corresponding author: Department of Pediatrics and Child Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. Email: eakitsa@gmail.com Received 2020 June 29; Accepted 2020 August 14. Abstract Background: Nephrotic syndrome is the most common glomerular disease affecting children, characterized by heavy proteinuria, edema, hypoalbuminemia, and hyperlipidemia. The mainstay treatment is with prednisolone, whose response is of prognostic sig- nificance. Steroid response rates vary across geographical regions, which may be due to the role of genetic and environmental risk factors among different ethnic groups. There is a paucity of data on response to treatment with prednisolone in pediatric patients with nephrotic syndrome in the Tigray region, Northern Ethiopia. Objectives: To assess the pattern of response to prednisolone in pediatric patients treated for nephrotic syndrome at Ayder Com- prehensive Specialized Hospital from 2014 to 2019. Methods: A record-based retrospective study was conducted at Ayder Comprehensive Specialized Hospital Mekelle City, Ethiopia. Data was collected and recorded on a predesigned form. Sixty-three patients fulfilled the inclusion criteria, whose data was entered, coded, and analyzed using the statistical software package (SPSS) version 20. Variables of interest included age, gender, blood pres- sure, presence of hematuria, acute kidney injury, biopsy, secondary causes of nephrotic syndrome, and response to steroid therapy. Data was presented in tables and graphs. Results: The age of the patients ranged from 1 - 17 years, with a median age of 3 years. Fifty-one patients (81%) were males, with a male to female ratio of 4.2:1. Hematuria was present in 66.7%, whereas hypertension was seen in 49.2% of the patients. Thirty-nine patients (61.9%) were responsive to prednisolone, 24 cases (38.1%) were resistant, 8 (20.5%) were steroid-dependent and 19 (48.7%) had relapses. Younger age (AOR 16.671, 95% CI: 1.645 - 168.904 P = 0.017) and high cholesterol values (AOR 1.013, 95% CI: 1.005 - 1.021 P = 0.01) were independent factors associated with steroid responsiveness. Conclusions: The steroid response rate in this study is similar to that in Asian and some African countries. Most patients in our hospital had atypical features of nephrotic syndrome. Younger age and high cholesterol levels were independent factors affecting steroid response. Keywords: Nephrotic syndrome, children, response 1. Background Nephrotic syndrome is the most common glomerular disease affecting children worldwide (1). It is character- ized by massive proteinuria, hypoalbuminemia, hyperlipi- demia, and edema, with normal renal function tests and no evidence of secondary causes of nephrotic syndrome (2, 3). Idiopathic, hereditary, and secondary forms are due to underlying increased protein leakiness across the glomerular capillary wall, as a result of immune and non- immune insults affecting the podocyte (3). Prednisolone is the mainstay treatment, whose re- sponse is often presumed to determine the long-term risk of disease progression and is a better prognostic indicator (2, 4). Although patients with steroid-sensitive nephrotic syndrome generally have good outcomes, more than half will have a frequently relapsing course and steroid de- pendence. Up to 95% of patients with minimal change nephrotic syndrome (MCNS) attain complete remission af- ter an 8-week course of high dose steroids (2). The response to treatment with steroids has been shown to vary by ethnicity, likely due to environmental Copyright © 2020, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.