Clinical Features And Outcome Of Childhood Nephrotic Syndrome In Calabar, Nigeria.

Abstract

BACKGROUND:
Nephrotic syndrome (NS) is a common childhood renal problem caused by impaired glomerular function, resulting in protein leakage into the urine. Most are idiopathic and respond to steroid therapy, however, steroid-sensitivity varies across geographical regions. The aim is to evaluate the clinical characteristics, the natural history, steroid responsiveness and outcome among children in Calabar, Nigeria.

METHODS:
A retrospective study carried out in the University of Calabar Teaching Hospital (UCTH), Calabar. Case folders of all children with Nephrotic Syndrome admitted from August, 2016 to July, 2022 were reviewed. Information obtained include age, sex, duration of illness before presentation, clinical features, urea/electrolyte/ creatinine results, duration of hospital stay, and outcome. Data was analyzed with SPSS version 22.0 and p-value < 0.05 was significant.

RESULTS:
Out of the one hundred and eighty-one renal patients, 30 (16.6%) had Nephrotic Syndrome, aged 2.4 to 17 years, mean age 11.3 + 4.0 years and a M:F ratio of 1.5:1. Oedema was the commonest feature affecting  mainly the face, abdomen, leg and scrotum. There were few atypical features of fever, cough, haematuria and hypertension. Most cases of NS were steroid sensitive (73.3%). Steroid Resistant NS and Frequent Relapse NS were 16.7% and 10.0% respectively. Many of the Steroid Resistant NS progressed to Chronic Renal Failure and EndStage Renal Disease. Most cases were discharge (90.0%), three left against Medical Advice and none died, but a good number were lost to followup.

CONCLUSION:
Oedema is the commonest presentation of Nephrotic syndrome in Calabar. Most were Steroid Sensitive NS with few Steroid Resistant NS and Frequent Relapse NS. Early presentation and prompt treatment enhanced our good outcome.