Idiopathic nephrotic syndrome in South African children.

Bakhiet, Yassir Mahgoub; Mudi, Abdullahi; Khumalo, Thandokuhle; Moonsamy, Glenda; Levy, Cecil

doi:10.4314/ahs.v17i4.22

Cited by 20 publications

(23 citation statements)

References 24 publications

(49 reference statements)

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“…B Prasun et al in their study on 88 children for 1 years found mean age on onset of NS to be 5.9±2.2 years while Bakhiet et al had 5.3±2.8 years as mean age of onset of NS in their study. 11,12 Our study male to female ratio was 2.23:1; El Bakkali et al13 study had male to female ratio of 2.9:1 while Other prospective study of 163 children done by Bakhiet et al 12 in Johannesburg, South Africa found out as 1.5:1, less compared to our study. This study was done in exclusive black race children and might have confounding effect.…”

Section: Discussioncontrasting

confidence: 60%

Urinary calcium and bone mineral density in children with nephrotic syndrome treated with glucocorticoids

Patil¹,

Reddy²

2020

Int J Contemp Pediatr

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Background: Mainstay of therapy in the idiopathic nephrotic syndrome is glucocorticoids. Glucocorticoid induced osteoporosis is considered as most prevalent type of secondary osteoporosis. Only limited studies are conducted in tropical nations. Therefore our study is undertaken with objectives to evaluate Glucocorticoid therapy impact on bone health in Nephrotic Syndrome (NS) children by 2 different tools, namely urinary calcium and bone mineral density (BMD) by Quantitative ultrasound (QUS) and compare both the tools.Methods: Total 42 children with NS who completed minimum 12 weeks of Glucocorticoid therapy (6 weeks of daily regimen and minimum 6 weeks of alternate day regimen) were subjected to 24 hour Urinary calcium and Bone Mineral density by QUS at Tertiary health centre, Kalaburagi.Results: Out of 42 cases, 45.2 % had Osteopenia and 2.4% had osteoporosis, so 47.6% of them had BMD measured by QUS. Hypercalciurea was seen in 10 out of 42 cases (23.8%). In normal BMD group only 0.5% had hypercalciurea, Osteopenia group had 47.4% of cases and all osteoporosis group had hypercalciurea.Conclusions: Present study data concludes that children with NS treated with Glucocorticoids are at risk of Negative impact on bone health. Though both the tools detect impact of Glucocorticoids on bone health, BMD by QUS has better rate then urinary calcium in detecting negative effect of Glucocorticoid on bone health. As BMD by QUS decreases, Urinary calcium increases reflecting inverse relation between them.

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Section: Discussioncontrasting

confidence: 60%

Urinary calcium and bone mineral density in children with nephrotic syndrome treated with glucocorticoids

Patil¹,

Reddy²

2020

Int J Contemp Pediatr

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“…approximately 70% of White children [9]. In New Orleans, USA, Kim showed that SRNS was four times more common in African Americans compared with children of European ancestry [12].…”

Section: Plos Onementioning

confidence: 99%

Changing epidemiology of nephrotic syndrome in Nigerian children: A cross-sectional study

2020

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Background Recent reports from small studies in West Africa suggest that Black children may have high rate of steroid sensitivity nephrotic syndrome (SSNS) contrary to long held knowledge. Herein, we determined the proportion of children with idiopathic nephrotic syndrome (INS) who achieved complete remission with steroid therapy and identified factors associated with complete remission. Methods We reviewed the medical records of 241 children with INS in two centres in Lagos from 2010 to 2019. We extracted demographic data, clinical features, laboratory values at the time of diagnosis, and receipt and response to steroids and other immunosuppressants. Results The median (interquartile range) age at diagnosis of INS was 5.1 (3.0-8.7) years and boys were 60.2% of the study population. Children with SSNS made up 85.9% (n = 207) of the study cohort. Among those aged 0-5 years, 92.6%were SSNS compared with 69.2% in those aged 11-17 years at the time of diagnosis. In addition, the proportion of children with SSNS increased from 73.8% between year 2010 and 2012 to 88.4% afterwards. Also, children with SSNS had lower serum creatinine (0.44 vs 0.70; p<0.001) and higher estimated glomerular filtration rate (101 vs 74.3 ml/min/1.73 m 2 ; p = 0.008) at the time of diagnosis than those with steroid resistant nephrotic syndrome (SRNS).

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“…Studies in developed countries show good response to steroids in childhood nephrotic syndrome, with resistance seen more in Hispanics and Blacks (2,4,7). In Africa, nephrotic syndrome secondary to infections was previously considered predominant, with most reports favoring non-MCNS forms and lower steroid response rates (4,(8)(9)(10). However, studies in Southwest and Enugu state Nigeria reported a high steroid responsiveness of 82.5% and 85.7%, respectively (11,12).…”

Section: Introductionmentioning

confidence: 99%

“…Hypertension, macroscopic hematuria, and decreased GFR, which are atypical features of nephrotic syndrome, occur more in secondary forms and are predictors of steroid resistance (2,9,14,16,17). Currently, an increasing trend of focal segmental glomerulosclerosis with concomitant increase in steroid resistance has been shown by studies in Caucasians, Asians, and as well as Africans (8,(18)(19)(20). Although studies exist in various regions elucidating the pattern of response to prednisolone in nephrotic syndrome patients, there are no studies in the Tigray region, Northern-Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Steroid Response Pattern Among Children with Nephrotic Syndrome in Northern Ethiopia

et al. 2020

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Background: Nephrotic syndrome is the most common glomerular disease affecting children, characterized by heavy proteinuria, edema, hypoalbuminemia, and hyperlipidemia. The mainstay treatment is with prednisolone, whose response is of prognostic significance. Steroid response rates vary across geographical regions, which may be due to the role of genetic and environmental risk factors among different ethnic groups. There is a paucity of data on response to treatment with prednisolone in pediatric patients with nephrotic syndrome in the Tigray region, Northern Ethiopia. Objectives: To assess the pattern of response to prednisolone in pediatric patients treated for nephrotic syndrome at Ayder Comprehensive Specialized Hospital from 2014 to 2019. Methods: A record-based retrospective study was conducted at Ayder Comprehensive Specialized Hospital Mekelle City, Ethiopia. Data was collected and recorded on a predesigned form. Sixty-three patients fulfilled the inclusion criteria, whose data was entered, coded, and analyzed using the statistical software package (SPSS) version 20. Variables of interest included age, gender, blood pressure, presence of hematuria, acute kidney injury, biopsy, secondary causes of nephrotic syndrome, and response to steroid therapy. Data was presented in tables and graphs. Results: The age of the patients ranged from 1 - 17 years, with a median age of 3 years. Fifty-one patients (81%) were males, with a male to female ratio of 4.2:1. Hematuria was present in 66.7%, whereas hypertension was seen in 49.2% of the patients. Thirty-nine patients (61.9%) were responsive to prednisolone, 24 cases (38.1%) were resistant, 8 (20.5%) were steroid-dependent and 19 (48.7%) had relapses. Younger age (AOR 16.671, 95% CI: 1.645 - 168.904 P = 0.017) and high cholesterol values (AOR 1.013, 95% CI: 1.005 - 1.021 P = 0.01) were independent factors associated with steroid responsiveness. Conclusions: The steroid response rate in this study is similar to that in Asian and some African countries. Most patients in our hospital had atypical features of nephrotic syndrome. Younger age and high cholesterol levels were independent factors affecting steroid response.

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Idiopathic nephrotic syndrome in South African children.

Cited by 20 publications

References 24 publications

Urinary calcium and bone mineral density in children with nephrotic syndrome treated with glucocorticoids

Urinary calcium and bone mineral density in children with nephrotic syndrome treated with glucocorticoids

Changing epidemiology of nephrotic syndrome in Nigerian children: A cross-sectional study

Steroid Response Pattern Among Children with Nephrotic Syndrome in Northern Ethiopia

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