Influence of disease remission on renal dimensions in childhood nephrotic syndrome in Ibadan, South West Nigeria

Abstract

Background: The hallmark of Nephrotic syndrome is massive proteinuria, with associated enlarged kidneys. However the association between remission status and size of the kidneys in patients with nephrotic syndrome is not known. This study is aimed at determining the dimensions of the kidneys of children with nephrotic syndrome and to compare kidney dimensions in patients with nephrotic syndrome who were in remission compared with the dimensions in patients who were not in remission.
Subjects and Methods: This is a case-control study, where fiftythree children with diagnosis of Nephrotic syndrome and fiftyseven age matched healthy controls were analysed. The kidneys of both cases and controls were scanned using the B- mode ultrasound and the kidneys Bipolar, anteroposterior and transverse dimensions and volume were determined.
Results: The mean renal longitudinal, anteroposterior, transverse dimensions and volume were higher in cases compared to the controls, bilaterally (p <0.001). The mean difference in values of the measured parameters between the cases in remission and those yet to attain remission was not significant. The bipolar dimension of the left kidney showed positive correlation with duration of disease (r= 0.290, p=0.035). The study was also able to demonstrate high incidence of nephromegaly, in 52.8%, 62.3% and 67.9% respectively for the right kidney, left kidney and combined.
Conclusion: Despite a comparative global enlargement in the kidney dimensions in children with nephrotic syndrome compared with controls and the general population, the remission status does not seem to be a significant factor.

Keywords: Nephrotic syndrome, renal dimensions, ultrasonography, nephromegaly, paediatric.