Clinicopathological report of children and young adults with nephrotic syndrome undergoing renal biopsy at workshops in Port Harcourt, Nigeria

Abstract

Background: Kidney biopsy is a procedure that is not commonly performed in Nigeria. This study reports the clinical and pathological findings in children who underwent renal biopsies during nephrology workshops held in Port Harcourt in 2014 and 2015. Methods: The native kidney biopsies were processed and evaluated using light microscopy only. Results: Nineteen patients (10 females) were biopsied. The mean age was 11.0 ± 6.5 years and the range was 1.8 to 21 years. Eleven patients had steroid-dependent nephrotic syndrome (SDNS) whereas eight were steroidresistant (SRNS). Hypertension and haematuria were present more often in SDNS. There were 11 cases (58%) with non-proliferative lesions, including minimal change disease (4 cases), focal segmental glomerulosclerosis (4 cases) and collapsing glomerulopathy (3 cases). The proliferative lesions (8 cases) included membranoproliferative (mesangiocapillary) glomerulonephritis (MPGN, 5 cases), mesangial proliferative glomerulonephritis (2 cases) and MPGN with collapsing glomerulopathy (1 case). Overall, the most common pathological diagnosis was MPGN (26%). Hypertension was more common with proliferative than with non-proliferative lesions (63% versus 36%). Conclusions: Although MPGN was the most common morphological lesion among children with nephrotic syndrome, bigger studies are necessary to confirm this. Efforts should be intensified in acquiring the expertise and infrastructure for performing and interpreting renal biopsies in Port Harcourt in order to optimize patient management.

Incidental Renal Disorders Found at Necropsies of Violent Death Victims

“…Proliferative glomerulonephritis like MPGN is considered a sequela of the overriding infectious processes inherent in our environment [12]. This is consistent with the reported high prevalence of Chronic Glomerulonephritis (CGN) as the most common cause of CKD in Nigeria [5,10,28,41].…”

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Volume 5 -Issue 2 and at end stage. This is worse in our environment where empirical treatment of nephrology patients' overrides biopsy based treatment [4,5]. Different authors have put forward research findings which suggest that age, environmental influence and race are contributory to the development and progression of CKD.

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