Differential Protein Clearances in Indian Children with the Nephrotic Syndrome

Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome

“…Understanding ethnic differences is important, because it may lead to better insight into reasons for the incidence of disease, the individual variability in response to medication, and the number of relapses. We report an extremely high incidence of NS in contrast to reports from India, where most studies are from tertiary centers treating more patients with complex cases, and there are few data from general pediatricians, which could greatly underestimate the burden of disease (7,25,26). Regional centers in England also report a five to six times higher incidence of NS among South Asians, predominantly those from northern India or Pakistan, compared with Europeans with limited long-term data (2,9).…”

Effect of indomethacin on glomerular permeability in the nephrotic syndrome

“…Studying 26 children, Lines (1969) found a good response to glycocorticosteroids in those with selective proteinuria. Chandra et al (1970) described a poor response to glycocorticosteroids in 16 out of 27 children with non-selective proteinuria; all but 3 of 21 children with an IgG clearance < 18% of albumin clearance showed a good to fair response to the medication. Hulme and Porter (1970) found low selectivity in 3 transplantation patients with recurrence of glomerulonephritis.…”

Differential protein clearances and response to treatment in Nigerian nephrotic children.

“…A few had substantial reduction of proteinuria with rise in serum albumin to normal levels, but without complete loss of proteinuria; this may also be an effect of steroid treatment, though spontaneous improvement, and effects of diet and general measures may also have contributed. Such a partial response is not recognized in nephrotic children from temperate regions, though it has been described in Delhi where malaria is rare (Chandra et al, 1970). The rest had persistent and heavy proteinuria and there was no appreciable or sustained rise in serum albumin.…”

“…There is a trend in this series which is not significant, for parasitaemia to be less common in those who responded than in those who did not, suggesting that though P. malariae is the probable cause of most of the latter, other causes may exist in the former. Since steroid-sensitive disease with highly selective proteinuria forms only a minority of nephrotic children in Delhi, where malaria is rare (Chandra et al, 1970), other infections which do not occur in temperate areas may also contribute aetiologically. It is interesting that steroid responders have an incidence of P. malariae parasitaemia probably higher than in the general population at this age.…”