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Primary nephrotic syndrome in Arab children in Kuwait
M Zaki1, I Helin, D S Manandhar
1Department of Paediatrics, Farwaniya Hospital, Kuwait.
Insights
Primary nephrotic syndrome (PNS) in Arab children shows a higher incidence compared to Western countries. Steroid response and relapse patterns in these children are similar to those observed globally.
Area of Science:
- Pediatrics
- Nephrology
- Epidemiology
Background:
- Primary nephrotic syndrome (PNS) is a significant kidney disorder in children.
- Understanding the epidemiology and clinical presentation of PNS in diverse populations is crucial for effective management.
Purpose of the Study:
- To determine the incidence and clinical characteristics of primary nephrotic syndrome in Arab children.
- To compare the findings with those reported in Western populations.
Main Methods:
- A retrospective study of 55 Arab children diagnosed with PNS over a 5-year period at two Kuwaiti hospitals.
- Analysis of patient demographics, initial response to steroid therapy, histopathological findings, and presence of hematuria.
Main Results:
- The annual incidence of PNS was 7.2 and 6.0 per 100,000 children under 10 and 12 years, respectively.
- 84% of children showed an initial response to steroids, with nearly 50% responding within one week.
- Among non-responders, membranoproliferative nephritis was the most common histopathological finding.
Conclusions:
- The incidence of PNS appears higher in Arab children compared to Western cohorts.
- The clinical presentation, steroid responsiveness, and relapse patterns of PNS in this cohort are consistent with international data.
Abstract:
Fifty-five Arab children with primary nephrotic syndrome (PNS) were seen at two regional hospitals in Kuwait over a 5-year period. There were 35 boys and 20 girls with a mean age of 5.3 years. The annual incidence was 7.2 and 6.0 per 100,000 children below 10 and 12 years of age, respectively. An initial response to steroids was noted in 84% with almost 50% responding within 1 week of therapy. Nine patients did not respond to steroids; histopathological classification of their renal biopsies showed 5 cases of membranoproliferative nephritis, 3 cases of focal segmental glomerulosclerosis and 1 case of membranous nephropathy. Microscopic haematuria was noted at presentation in 7 of 46 steroid responders, in all 5 patients with membranoproliferative disease and in 1 of 3 with focal segmental glomerulosclerosis. We conclude that the incidence of PNS seems to be higher among Arab children than in Western countries. With regard to initial biochemical abnormalities, steroid response and subsequent relapses, the pattern is the same as elsewhere.