EPIDEMIOLOGY AND CLINICOPATHOLOGIC CHARACTERISTICS OF CHILDHOOD NEPHROTIC SYNDROME IN LIBYA SINGLE CENTER EXPERIENCE

Abstract

Idiopathic, non-congenital Nephrotic syndrome (NS) of childhood is characterized by massive proteinuria and hypo-albuminemia, leading to oedema and hypercholesterolemia. Other clinical findings, such as haematuria and hyper-tension, are observed in a small fraction of patients. To identify the exact pattern of NS in Libyan children, inci-dence of disease, and out-comes of NS. This study was retrospectively carried out on 329 children (227 male and102 female), male: female was 2.2:1, aged (mean=4.9 ±3.2 year) at the onset of the disease. All patients with Idiopathic Nephrotic Syndrome. This diagnosis was made according to the criteria of the international study of kid-ney disease in children (ISKD). An average admission at Nephrology ward was 214 cases/ year; correspond to 5% of total hospital admission. 30.3 % were newly diagnosed Nephrotic Syndrome (65 newly diagnosed nephrotic pa-tients ∕ year). Sixty nine % of children were with good sensitivity to steroid, 24.3% with steroid dependent and 6.7% were steroid resistant. Viral screen was done in 226 patients 68% ,28 children were positive for HCVAb by ELISA 8.5% of total cases,HBSAg was positive in one female ,no one with HIV. HCVAb positive cases 78.57% of them were steroid dependent & steroid resistant with frequent admission. The out-comes were as follow; 18 patients got hypertension, one patient with DM, two patients with hypothyroidism, one patient with cataract and glaucoma , 8 patients were died and 135( 41.3%) got complete remission. with regular treatment and follow up, the prognosis of idiopathic Nephrotic syndrome is good,with better organized schedules of management, has substantially reduced the Mortality of SRNS (steroid responder Nephrotic syndrome), but death still occurs, primarily from hypovolemia, Thrombosis and sepsis. Relapses eventually cease. Blood pressure and renal function remain Normal.