501 INCIDENCE OF MINIMAL LESION NEPHROSIS IN EASTERN KENTUCKY

Abstract

The etiology of minimal lesion nephrosis (MLN), the most common cause of nephrotic syndrome in children, is unknown. The only incidence data on MLN have been extrapolated from population surveys of nephrotic syndrome in childhood performed over 20 years ago. These studies estimated the incidence of MLN at 1.5 cases per year per 100,000 children, ages 1-9. New cases of MLN occurring during the years 1970-1979 were identified by survey of area pediatricians and by medical record review of 9 hospitals in the area most likely to care for children. Total population of the study area in 1974 was 1.1 million with 187,000 children, ages 1-9. Thirty-five cases of MLN were identified with onset after first and before tenth birthday. Criteria for identification were initial response to daily steroids (33 pts) with complete clearing of proteinuria in <1 month or initial non-response (2 pts) with both renal biopsy and subsequent clinical course compatible with MLN. Incidence of MLN in the study area was 1.9 cases per year per 100,000 children, ages 1-9. However, in one rural 5-county area the incidence was 4.7 cases per year per 100,000. Whether this cluster of cases is epidemiologically meaningful or a statistical artifact is uncertain. Further refinement of the distribution and demographics of cases in the high rate area may provide clues to the etiology of MLN and continuing surveillance of area will enable us to assess the reliability of the finding.

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