Chronic kidney disease in children with Nephrotic Syndrome seen in a Tertiary Hospital In Kano, Northern Nigeria

Abstract

Background: Nephrotic syndrome (NS) is one of the most common manifestations of paediatric glomerular disease and is known to have various histological subtypes. Certain subtypes of NS are more resistant to therapy than other subtypes. Resistance to therapy is associated with an increased risk of development of chronic kidney disease (CKD). The prevalence of CKD is known to be on the rise worldwide. However, the frequency of occurrence of CKD in children with nephrotic syndrome (NS) in this region is rarely studied. This study aims to shed some light on the issue.

Materials and Methods: A review of cases of NS seen in the outpatient clinic was done. Standard case definitions were used. Patients were classified into different categories of NS – steroid-sensitive (SSNS), steroid-dependent (SDNS) and steroid-resistant (SRNS). Those who had kidney biopsy were also identified and their histological diagnoses were classified. Patients with chronic kidney disease (CKD) were determined using the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.

Results: Eighty-two patient records were analysed. Male to female ratio was 2.3:1. Sixty-six children (79.8%) presented at over 5 years of age. Mean age was 8.4 ± 3.0 years. Thirty-five patients (42.7%) had received a kidney biopsy. SRNSwas seen in 35 patients (42.7%) while 29 children (35.4%) hadCKD. Of the children with SRNS, 79.3% had CKD. Fourteen of the biopsied children had focal segmental glomerulosclerosis (FSGS). Of these, 8 (57.1%) had CKD.

Conclusion: CKD is common in children with nephrotic syndrome and more prevalent in those with steroid resistance.

Keywords: Steroid-resistant nephrotic syndrome, chronic kidney disease, children, Nigeria.