BackgroundDifferent histo-pathological types and treatment response patterns of Idiopathic nephrotic syndrome (INS) have been associated with differences in ethnicity and geographical location.ObjectiveTo provide an update on the steroid response and renal histo-pathological pattern in children treated for INS.MethodMedical records of children with INS treated at the Charlotte Maxeke Johannesburg Academic Hospital were reviewed.ResultsMean 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%).ConclusionThere 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.

Introduction: Acute kidney injury in pediatric patients (pAKI) is common in developing countries and leads to significant morbidity and mortality. Most nephrology services in developing countries are only in larger cities and for that reason many cases remain undiagnosed. We evaluated the performance of a saliva urea nitrogen (SUN) dipstick to diagnose pAKI in Sudan. Methods: We collected demographic and clinical information, serum creatinine (SCr), blood urea nitrogen (BUN), SUN, and urine output (UO) in children with pAKI. pAKI was diagnosed based on different criteria (Risk, Injury, Failure, Loss of kidney function, and end-stage kidney disease, Acute Kidney Injury Network and Kidney Disease Improving Global Outcomes). We also recorded hospital and 3-months’ mortality and progression to chronic kidney disease (CKD) as outcomes. Results: We studied 81 patients (mean age 10.7 ± 7 years, 51.9% females) and divided them by age into (a) neonates (<120 days; n = 21; 25.9%); (b) ­infants (120–365 days; n = 18; 25.9%); and (c) children (>365 days; n = 42; 53.1%). Diagnosis using different pAKI definitions resulted in differences in AKI staging. SUN reliably reflected BUN over the entire study period, regardless of treatment modality or pAKI severity. Neither pAKI staging, SUN, BUN, nor SCr were associated with mortality or progression to CKD. UO predicted all-cause mortality during the 3-months follow-up. Conclusion: Diagnosis of pAKI using different criteria differs in triage and staging. SUN reflects BUN particularly at higher BUN levels and allows monitoring of treatment responses. Despite the lack of predictive power of SUN to predict hard outcomes, measurement of SUN by dipstick can be used to identify, screen, and monitor pediatric patients with pAKI.

Background and Aims Sudan is a large Sub-Saharan country with a population of about 48 million people, 41% of them under the age of 15 years and a median age of 18.9 years. To data, no data have been reported on the etiology of end stage kidney disease (ESKD) in children and young adults of less than 18 years of age. Method We conducted a chart review of all ESKD patients below the age of 18 years treated in a tertiary referral center, the Soba University Hospital (SUH) in Khartoum, the capital of Sudan. The research was approved by the SUH ethical committee. We report descriptive statics, including age, sex, ESKD causes, and kidney biopsy frequency. Results We included 885 patients in this analysis, their mean age (SD) was 12 (3.0) years and 57.7% were males. Glomerulonephritis, mostly post-streptococcal glomerulonephritis, was the leading cause of ESKD (36.8%), followed by unknown etiologies (25.3%) and congenital anomalies of kidney and urinary tract (CAKUT; 14.9%). In most patients with glomerulonephritis the diagnosis was based on kidney histology (96.6%). ESKD was attributed to HUS in about 7% of patients. As expected, SLE was more prevalent in females (3:1 ratio) and hereditary nephritis in males (3:1). Conclusion Glomerulonephritis and CAKUT account for over 50% of pediatric ESKD patients in this study from a tertiary referral center in Sudan.

The AUC value of a panel of four biomarker candidates were higher than single biomarkers that reflects the value of simultaneous measurement of these four metabolite candidates than single candidates. Table 2 shows the list of diagnostic metabolite candidates with p < 0.05 and FC > 1.2.Pathway characterization was used to better understanding of pathophysiology of CIN. Only "Histidine_ lysine_ phenylalanine, tyrosine, proline and tryptophan catabolism" pathway (p < 0.05) was significant and suggested as the most important disturbed pathway in CIN. Conclusions: Early detection of CIN, after using contrast can help better management of this complication. In this study, only after 4 hours passed from using contrast media a panel of metabolites were found in urine of patients who developed CIN. This is the first study to investigate urine metabolic profile using NMR-based metabolomics for early detection of CIN after coronary angiography. The use of this suggested panel might significantly improve clinical consequences of this harmful complication.