Nephrotic syndrome in Nepalese children: clinical profile, histopathology and outcome in a tertiary care center of Nepal.

Abstract

Introduction: The demographic, clinical features, steroid response, histopathology and complications of all children diagnosed with nephrotic syndrome at Tribhuvan University Teaching Hospital over a 3-year period.

Methods: A retrospective study was conducted among patients who were admitted in the Pediatrics ward of Tribhuvan University Teaching Hospital with the diagnosis of Nephrotic syndrome from April 2010 to April 2013.

Results: During the study period from 2010 April to 2013 April, there were total of 80 patients admitted with the diagnosis of nephrotic syndrome. There was male preponderance with sex ratio 1.28:1. Mean age of patient at first episode was 8.51±4.33 years. Among the admitted patients, 48.8% (41) of children had single episode whereas steroid resistance was observed in 16.2% (13) of patients. Hematuria and hypertension were present in 21.2% (7) and 50% (40) of patients respectively. Renal dysfunction was present in 21.2% (17). Pneumonia was the most common complications 18.8% (15), followed by UTI 8.8%(7), spontaneous bacterial peritonitis 3.8% (3) and acute renal failure 7.5% (8). Two patients had multiple complications. Alternative therapies were used in 25% (20) of patients and cyclophosphamide was used most commonly as alternative therapy which was used in 17.4% (14). Most common histopathological diagnosis was FSGS 30.3% (10) followed by MPGN 15.5% (5), SLE nephropathy 15.5% (5) and IgA nephropathy 15.5% (5)

Conclusion:

The clinical course of childhood NS in Nepal is similar to the developed world. Differences at Presentation included older age and increased prevalence of microscopic hematuria, hypertension