Idiopathic nephrotic syndrome in South African children.

Yassir Mahgoub Bakhiet1,2, Abdullahi Mudi1,2,3, Tholang Khumalo1,2,
Glenda Moonsamy1,2, Cecil Levy1,2
1. Division of Paediatric Nephrology, Department of Paediatrics and Child Health, Charlotte
Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
2. Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
3. Department of Paediatrics, Faculty of Clinical Sciences, College of Health Sciences, Bayero
University, Kano, Nigeria.

Abstract
Background: Different histo-pathological types and treatment response patterns of Idiopathic nephrotic syndrome (INS) have
been associated with differences in ethnicity and geographical location.

Objective: To provide an update on the steroid response and renal histo-pathological pattern in children treated for INS.

Method: Medical records of children with INS treated at the Charlotte Maxeke Johannesburg Academic Hospital were reviewed.

Results: Mean age was 5.3 years ± 2.8. The majority (68.1%) of the 163 children were of the black racial group. The highest rate of INS was seen in the 2-6 year age group (71.2%). The black racial group had the highest rate (42/111; 37.8%) of focal segmental glomerulosclerosis (FSGS), and the white race had the highest rate (9/14; 64.3%) of minimal change disease (MCD). Ninety four (57.7%) patients were steroid sensitive (SSNS) while 69 patients (42.3%) were steroid resistant (SRNS). Minimal change disease was the most common histo-pathological type seen in SSNS (60%), while FSGS was the most common observed in patients who had SRNS (65.2%).

Conclusion: There appears to be a higher rate of FSGS in all the racial groups, and also a higher rate of MCD in the black race
group, when compared to previous reports.

Keywords: Idiopathic, nephrotic syndrome, children