Abderraman, G.M.; Djidita, H.Y.; Mahamat, H.A.; Charfadine, S.; Amne, A.S.; Khadidja, A.A.; Rostaing, L. Idiopathic Nephrotic Syndrome in Children in Chad: Epidemiology and Clinical Outcomes. J. Clin. Med.2023, 12, 7626.
Abderraman, G.M.; Djidita, H.Y.; Mahamat, H.A.; Charfadine, S.; Amne, A.S.; Khadidja, A.A.; Rostaing, L. Idiopathic Nephrotic Syndrome in Children in Chad: Epidemiology and Clinical Outcomes. J. Clin. Med. 2023, 12, 7626.
Abderraman, G.M.; Djidita, H.Y.; Mahamat, H.A.; Charfadine, S.; Amne, A.S.; Khadidja, A.A.; Rostaing, L. Idiopathic Nephrotic Syndrome in Children in Chad: Epidemiology and Clinical Outcomes. J. Clin. Med.2023, 12, 7626.
Abderraman, G.M.; Djidita, H.Y.; Mahamat, H.A.; Charfadine, S.; Amne, A.S.; Khadidja, A.A.; Rostaing, L. Idiopathic Nephrotic Syndrome in Children in Chad: Epidemiology and Clinical Outcomes. J. Clin. Med. 2023, 12, 7626.
Abstract
Introduction: Nephrotic syndrome (NS) remains the most frequent mode of presentation of glo-merular diseases in children; in addition, the NS is primitive, i.e., idiopathic in 90% of cases with an average age of onset between 2 and 10 years. The objective of our study was to describe the char-acteristics and outcome of NS in children from 3 major hospitals from one of the poorest countries worldwide (Chad).
Patients and Methods: Observational, cross-sectional, descriptive and multicenter study which took place over a period of 36 months (January 1,2019-December 31,2021) carried out in 3 hospitals in N’Djamena (Chad). All children aged 1-15 years presenting with NS were included.
Results: Out of 16,776 children hospitalized or followed-up in outpatient clinics, 24 cases of NS were identified, giving a prevalence of 0.14%. The median age at presentation was 6.16(1-10) years. Nineteen children were male (sex ratio 3.8). There were 8 impure NS (33.3%). Edema was present in all patients, oliguria in 29.16%(n=7), and arterial hypertension in 20.83%(n=5) of cases. Mean proteinuria, albuminemia and total proteins were 2.86g/L, 19.13g/L and 30.41g/L respectively. Median serum creatinine was 87.3 µmol/L(75-1375µmol/L); three patients had acute renal failure on admission. Four patients had secondary NS. All patients (n=20) with idiopathic NS had received corticosteroid therapy; steroid-sensitivity was found in 90% of patients. Those who were not ster-oid-sensitive or relapsed underwent kidney biopsy (n=7); the most represented histological lesion was focal segmental glomerulosclerosis (FSGS; n=4), followed by minimal change disease (n=2), and membranoproliferative glomerulonephritis (n=1). The median length of hospitalization stay was 10.67 (5-27) days. None of the patients with idiopathic NS died. At last follow-up sixteen patients (80%) achieved long-term complete remission with normal renal function; however, 4 had subse-quent relapses. 16 patients. One patient with secondary NS died.
Conclusion: In Chad childhood idiopathic nephrotic syndrome involves mostly young male; steroid sensitivity is as high as 95% and in the long-term 80% of the patients are in remission with normal renal function.
Keywords
nephrotic syndrome; pediatrics; nephrology; steroids; FSGS; Chad; sub-Saharan countries
Subject
Medicine and Pharmacology, Urology and Nephrology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
