A Pattern of Glomerular Diseases in Egyptian Children: A Single-center Experience

Hoda Atef Abdelsattar Ibrahim; Aya Amin; Ahmed Zeid; Samar Sabry; Hesham Safouh

doi:10.3889/oamjms.2021.7142

Authors

Hoda Atef Abdelsattar Ibrahim Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
Aya Amin Department of Biostatistics and Cancer Epidemiology, National Cancer Institute, Cairo University, Giza, Egypt
Ahmed Zeid Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
Samar Sabry Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
Hesham Safouh Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.7142

Keywords:

Glomerular diseases, Patterns of presentation, Pediatrics

Abstract

BACKGROUND: Findings indicative of the glomerular disease are proteinuria, hematuria, nephrotic syndrome (NS), hypertension, and renal insufficiency. These presentations can be used to define different clinical patterns that resemble different underlying etiologies.

METHODS: This study is a cross-sectional study enrolled in Children Hospital Cairo University. The study participants were recruited on two stages, retrospective and prospective stages. In the retrospective stage, all eligible patients across 5 years (between 2011 and 2015) with any glomerular disease were included in the study. In addition, prospectively, the new cases a long 6 months (from February 2016 till July 2016) with glomerular diseases were included in the study.

RESULTS: A total of 594 cases with different glomerular diseases were identified. Cases were two groups: The retrospective group that involved 543 cases and the prospective group that included 51 cases. In the retrospective part of the study, the most common presentations were NS (68%), nephritis (16.4%), gross hematuria (10.5%), and nephrotic/nephritic syndrome (3.5%). The most common biopsies in the retrospective study were NS: MCNS (27.3%), NS: focal segmental glomerulosclerosis (FSGS) (23.4%), NS: Mesangioproliferative GN (9.4%), NS: Membranous GN (2.3%), Crescentric GN (3.9%), Membranous GN (0.8%), MPGN (0.8%), congenital nephrotic syndrome (CNS):Diffuse Mesangial Sclerosis (3.9%), CNS: Finnish type (2.3%), Alport (4.7%), IgA nephropathy (3.9%), IgM nephropathy (1.6%), lupus nephritis (LN) (3.1%), Thin basement membrane disease (3.1%), and others (9.4%) In the prospective study, the most common presentations were NS (76.5%), nephritis (11.8%), nephrotic/nephritic syndrome (7.8%), and gross hematuria (3.9%). The biopsies results were mainly NS: FSGS (33.3%) and NS: MCNS (33.3%). Other biopsies results in the prospective part were NS: Mesangioproliferative GN (16.7%), LN (8.3%), and IgA nephropathy (8.3%).

CONCLUSION: The most common glomerular disease in childhood is NS. The most common pathology of glomerular diseases is minimal change NS.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Hebert LA, Parikh S, Prosek J, Nadasdy T, Rovin BH. Differential diagnosis of glomerular disease: A systematic and inclusive approach. Am J Nephrol. 2013;38(3):253-66. https://doi.org/10.1159/000354390 PMid:24052039 DOI: https://doi.org/10.1159/000354390

Thakkar K, Poyekar S. Pattern of pediatric renal diseases in a rural tertiary care hospital. Int J Contemp Pediatr. 2020;7:2152-6. DOI: https://doi.org/10.18203/2349-3291.ijcp20204542

Garyal, Kafle RK. Hisopathological spectrum of glomerular disease in Nepal: A seven-year retrospective study. Nepal Med Coll J. 2008;10(2):126-8. PMid:18828437

Khakurel S, Agrawal RK, Hada R. Pattern of glomerular disease in Nepal: A single-center experience. Saudi J Kidney Dis Transpl. 2015;26(4):833-8. https://doi.org/10.4103/1319-2442.160249 PMid:26178570 DOI: https://doi.org/10.4103/1319-2442.160249

Hurtado A, Escudero E, Stromquist CS, Urcia J, Hurtado ME, Gretch D, et al. Distinct patterns of glomerular disease in Lima, Peru. Clin Nephrol. 2000;53(5):325-32. PMid:11305805

AlYousef A, AlSahow A, AlHelal B, Alqallaf A, Abdallah E, Abdellatif M, et al. Glomerulonephritis histopathological pattern change. BMC Nephrol. 2020;21(1):186. https://doi.org/10.1186/s12882-020-01836-3. PMid:32423387 DOI: https://doi.org/10.1186/s12882-020-01836-3

Makris K, Spanou L. Acute kidney injury: Definition, pathophysiology and clinical phenotypes. Clin Biochem Rev. 2016;37(2):85-98. PMid:28303073

Chapter 1: Definition and classification of CKD. Kidney Int Suppl. 2013;3(1):19-62. https://doi.org/10.1038/kisup.2012.64 PMid:25018975 DOI: https://doi.org/10.1038/kisup.2012.64

Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63(5):713-35. https://doi.org/10.1053/j.ajkd.2014.01.416 PMid:24647050 DOI: https://doi.org/10.1053/j.ajkd.2014.01.416

Mortazavi F, Khiavi YS. Steroid response pattern and outcome of pediatric idiopathic nephrotic syndrome: A single-center experience in Northwest Iran. Ther Clin Risk Manag. 2011;7:167-71. https://doi.org/10.2147/TCRM.S19751 PMid:21691587 DOI: https://doi.org/10.2147/TCRM.S19751

Abdelraheem MB, Ali EM, Mohamed RM, Hassan EG, Abdalla OA, Mekki SO, et al. Pattern of glomerular diseases in Sudanese children: A clinico-pathological study. Saudi J Kidney Dis Transpl. 2010;21(4):778-83. PMid:20587895

Asif N, Mukhtar KN, Adnan F. Spectrum of glomerular diseases: An 11 year retrospective review in a tertiary care hospital in Pakistan. JUMDC. 2015;6:54-8.

Clement WD, Viswanath MV, Mahesh E, Rashmi K, Radhika K. Pattern of glomerular disease in patients with nephrotic syndrome-a single Centre South Indian study. Ann Int Med Dent Res. 2015;1(3):281-8.

Shawarby M, Al Tamimi D, Al Mueilo S, Saeed I, Hwiesh A, Al-Muhanna F, et al. A clinico pathologic study of glomerular disease: Experience of the king Fahd hospital of the University, Eastern Province, Saudi Arabia. Hong Kong J Nephrol. 2010;12:20-30. DOI: https://doi.org/10.1016/S1561-5413(10)60005-1

Arias, Luis Fernando et al. Glomerular diseases in a Hispanic population: Review of a regional renal biopsy database. Sao Paulo Med J. 2009;127(3):140-4. https://doi.org/10.1590/s1516-31802009000300006 PMid:19820874 DOI: https://doi.org/10.1590/S1516-31802009000300006

Mahmud HM, Kumar D, Irum H, Ali SF. Glomerular diseases outcome at one year in a tertiary care Centre. Pak J Med Sci. 2015;31(2):462-6. https://doi.org/10.12669/pjms.312.6779 PMid:26101512 DOI: https://doi.org/10.12669/pjms.312.6779

Srisawat N, Aroonpoonsub L, Lewsuwan S, Kanjanabuch T, Avihingsanon Y, Praditpornsilpa K, et al. The clinicopathology and outcome of post-infectious glomerulonephritis: Experience in 36 adults. J Med Assoc Thai. 2006;89(2):S157-62. PMid:17044468

Nickavar A, Harahdashti AL. Trends in steroid response among children with idiopathic nephrotic syndrome. Iran J Kidney Dis. 2014;8(5):389-93. PMid:25194406