Idiopathic nephrotic syndrome in South African children
Yassir Mahgoub Bakhiet1,2, Abdullahi Mudi1,2,3, Tholang Khumalo1,2
1Division of Paediatric Nephrology, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
Insights
Idiopathic nephrotic syndrome (INS) in children shows varied patterns. Focal segmental glomerulosclerosis (FSGS) is more common in black children, while minimal change disease (MCD) is prevalent in steroid-sensitive cases.
Area of Science:
- Pediatric Nephrology
- Renal Pathology
- Immunology
Background:
- Idiopathic nephrotic syndrome (INS) exhibits diverse histopathological types and treatment responses.
- These variations are often linked to ethnicity and geographic origin.
Purpose of the Study:
- To update knowledge on steroid response and renal histopathology in children with INS.
- To analyze patterns specific to the South African population.
Main Methods:
- Retrospective review of medical records for children diagnosed with INS.
- Data collected from Charlotte Maxeke Johannesburg Academic Hospital.
Main Results:
- 163 children studied; mean age 5.3 years. Black children constituted the majority (68.1%).
- Focal segmental glomerulosclerosis (FSGS) was more prevalent in the black racial group (37.8%), while minimal change disease (MCD) was higher in the white racial group (64.3%).
- 57.7% were steroid-sensitive (SSNS), 42.3% steroid-resistant (SRNS). MCD was common in SSNS (60%), FSGS in SRNS (65.2%).
Conclusions:
- Higher rates of FSGS observed across racial groups and MCD in the black population compared to prior studies.
- Findings suggest potential ethnic and geographic influences on INS pathology and steroid response.
Background:
Different histo-pathological types and treatment response patterns of Idiopathic nephrotic syndrome (INS) have been associated with differences in ethnicity and geographical location.
Objective:
To provide an update on the steroid response and renal histo-pathological pattern in children treated for INS.
Method:
Medical records of children with INS treated at the Charlotte Maxeke Johannesburg Academic Hospital were reviewed.
Results:
Mean age was 5.3 years ± 2.8. The majority (68.1%) of the 163 children were of the black racial group. The highest rate of INS was seen in the 2-6 year age group (71.2%). The black racial group had the highest rate (42/111; 37.8%) of focal segmental glomerulosclerosis (FSGS), and the white race had the highest rate (9/14; 64.3%) of minimal change disease (MCD). Ninety four (57.7%) patients were steroid sensitive (SSNS) while 69 patients (42.3%) were steroid resistant (SRNS). Minimal change disease was the most common histo-pathological type seen in SSNS (60%), while FSGS was the most common observed in patients who had SRNS (65.2%).
Conclusion:
There appears to be a higher rate of FSGS in all the racial groups, and also a higher rate of MCD in the black race group, when compared to previous reports.
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