Primary nephrotic syndrome in children in Cape Town, South Africa

D Reddy, A Coetzee, K Webb, M McCulloch, P Nourse
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Abstract

Background. Histopathological patterns of childhood primary nephrotic syndrome (PNS) and clinical response to steroids have beenassociated with certain race groups in parts of South Africa. However, there are no recent studies of childhood PNS in Cape Town.Objectives. To describe the demographics, histological subtypes and steroid response of patients with PNS who underwent kidney biopsiesat Red Cross War Memorial Children’s Hospital (RCWMCH) over a 10-year period.Methods. Details of patients with PNS who underwent kidney biopsies in the Paediatric Nephrology Department at RCWMCH between2006 and 2015 were retrospectively recorded.Results. A total of 103 patients were included in the study. Most patients were either of mixed race (42%) or black (36%), with a mean age of6.8 years and a male-to-female ratio of 1.19:1. The most identified histopathological subtype was mesangioproliferative glomerulonephritis(MesPGN; 60% (n/N=62/103)). Of the patients with focal segmental glomerulosclerosis (FSGS), MesPGN and minimal change disease(MCD) 45% (n/N=43/95) were steroid-resistant, and 54% (n/N=51/95) were steroid-sensitive. There was no significant associationbetween any race group and steroid response. Patients with FSGS were more likely to be black, while MCD was more common in mixed-race patients (p=0.04). There was no difference in the likelihood of being mixed race or black between patients with FSGS and MesPGN(p=0.472).Conclusion. MesPGN was the most common histopathological subtype found in our study. There was no significant association betweenrace and steroid response. Patients with FSGS were more likely to be black than mixed race when compared with MCD patients. Race wasnot otherwise significantly associated with any histopathological subtype
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南非开普敦儿童原发性肾病综合征
背景。在南非部分地区,儿童原发性肾病综合征(PNS)的组织病理学模式和对类固醇的临床反应与某些种族群体有关。然而,最近在开普敦没有关于儿童PNS的研究。描述在红十字战争纪念儿童医院(RCWMCH)接受肾活检的PNS患者10年期间的人口统计学、组织学亚型和类固醇反应。回顾性记录2006年至2015年期间在RCWMCH儿科肾内科接受肾活检的PNS患者的详细信息。研究共纳入103例患者。大多数患者为混血(42%)或黑人(36%),平均年龄为6.8岁,男女比例为1.19:1。最常见的组织病理学亚型是系血管增殖性肾小球肾炎(MesPGN;60% (n / n = 62/103))。局灶节段性肾小球硬化(FSGS)、MesPGN和最小改变病(MCD)患者中,45% (n/ n =43/95)为类固醇耐药患者,54% (n/ n =51/95)为类固醇敏感患者。任何种族和类固醇反应之间没有明显的联系。FSGS患者多为黑人,而MCD患者多为混血儿(p=0.04)。FSGS患者与MesPGN患者混血或黑人的可能性无差异(p=0.472)。MesPGN是我们研究中发现的最常见的组织病理学亚型。在种族和类固醇反应之间没有明显的关联。与MCD患者相比,FSGS患者更有可能是黑人而不是混血儿。种族与任何组织病理学亚型均无显著相关性
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CiteScore
0.60
自引率
0.00%
发文量
21
审稿时长
12 weeks
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