Nephrotic syndrome among children in Kano: a clinicopathological study

To evaluate the clinicopathological features of children with nephrotic syndrome seen in a pediatric nephrology unit in northern Nigeria.

All children less than 15 years of age who had nephrotic syndrome and who had been subjected to renal biopsy at Aminu Kano Teaching Hospital, Kano, were studied. Their histologic diagnoses were evaluated alongside clinical and other laboratory parameters.

Twenty children, 17 males and three females, were studied. These represented 55% of all children with nephrotic syndrome seen in the pediatric nephrology unit during the study period, the rest of which have never had renal biopsies. Peak age was 7-8 years (range 2.5-13 years). Fourteen of the 20 children (70%) had previously been on steroid treatment. Of these, 11 (55%) were classified to be steroid resistant and three (15%) were frequent relapsers. Six (30%) children were newly diagnosed with nephrotic syndrome and had not commenced steroid treatment. Hypertension was found in seven (35%) children. Sixteen children (80%) had microscopic hematuria on presentation. The most common histopathological diagnosis was focal glomerulosclerosis in nine (45%) children (segmental = 8; global = 1). Minimal change disease was found in four children (20%), membranoproliferative glomerulonephritis in three children (15%), membranous nephropathy in three children (15%), and diffuse mesangial hypercellularity in one child (5%). Of the six children who had renal biopsy before commencement of steroid treatment, three (50%) were found to have glomerulosclerosis.

Focal segmental glomerulosclerosis was the most common histological subtype diagnosed in Kano among children with nephrotic syndrome in this study.