{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:31:40Z","timestamp":1786480300839,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","funder":[{"DOI":"10.13039\/sphd4mbuydbd","name":"Mitsubishi Tanabe Pharma","doi-asserted-by":"publisher","award":["QMTPS20200420001"],"award-info":[{"award-number":["QMTPS20200420001"]}],"id":[{"id":"10.13039\/sphd4mbuydbd","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/sph1ucdsigld","name":"Japan Society for the Promotion of Science KAKENHI","doi-asserted-by":"publisher","award":["JP 20K16848"],"award-info":[{"award-number":["JP 20K16848"]}],"id":[{"id":"10.13039\/sph1ucdsigld","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prognosis of steroid-resistant nephrotic syndrome (SRNS) in children is poorer than steroid-sensitive cases. Diagnosis of SRNS is made after observing the response to the initial 4-week corticosteroid therapy, which might be accompanied by side effects. However, predictive indicators at initial diagnosis remain unknown. We aimed to investigate whether selectivity index (SI) and other indicators at initial diagnosis\u2014for example, serum IgM and total serum protein\u2013albumin ratio (TA ratio, total serum protein level over albumin level)\u2014can predict SRNS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 80 children were enrolled from seven hospitals in Japan between January 2008 and December 2019 (mean age, 4.7 years; 65% male). Of the children enrolled, 13 (16%, M\/F=5:8) had been diagnosed as steroid resistant after initial treatment with steroids. The association between serum IgM (tertile categories: low, 24\u2013133; middle, 134\u2013169; and high, 169.1\u2013510 mg\/dl), SI (&lt;0.2 or \u22650.2), and TA ratio (tertile categories: low, 1.8\u20132.6; middle, 2.62\u20133.75; and high, 3.8\u201315.3) at initial diagnosis and steroid resistance was evaluated with logistic regression, adjusting for age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Low levels of serum IgM were significantly associated with steroid resistance (adjusted odds ratio, 6.94; 95% CI, 1.12 to 43.11). TA ratio and SI were not significantly associated with steroid resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low levels of serum IgM at initial diagnosis might predict steroid resistance among Japanese children with idiopathic nephrotic syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0004432020","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T17:06:51Z","timestamp":1611076011000},"page":"487-493","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Association between Immunoglobulin M and Steroid Resistance in Children with Nephrotic Syndrome: A Retrospective Multicenter Study in Japan"],"prefix":"10.34067","volume":"2","author":[{"given":"Tomohiro","family":"Udagawa","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Okutsu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaeko","family":"Motoyoshi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tokyo Kita Medical Center Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Musashino Red Cross Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norimasa","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tsuchiura General Hospital, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eriko","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nerima Hikarigaoka Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masuhiro","family":"Shimoda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nerima Hikarigaoka Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Kanamori","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan"},{"name":"Department of Pediatrics, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae","family":"Omori","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohsuke","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Community Pediatrics, Perinatal, and Maternal Medicine, Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akifumi","family":"Endo","sequence":"additional","affiliation":[{"name":"Medical Innovation Promotion Center, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Morio","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"key":"B1-20250825","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(03)14184-0","article-title":"Nephrotic syndrome in childhood","volume":"362","author":"Eddy","year":"2003","journal-title":"Lancet"},{"key":"B2-20250825","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00467-012-2310-x","article-title":"Treatment of steroid-sensitive nephrotic 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