CHILDHOOD NEPHROTIC SYNDROME -A SINGLE CENTRE EXPERIENCE IN ALTHAWRA CENTRAL HOSPITAL, ALBAIDA-LIBYA DURING 2005-2016

Mabrouka A. M. Bofarraj*, Fatma S. Ben Khaial, Najwa H. Abduljawad and Rima Alshowbki

ABSTRACT

The aim of this study to determine respose to treatment in terms of remission and relapse, related risk factors, type of management and complications of nephrotic syndrome among studied patients. Design: Retrospective, analytical study. Setting: Pediatric nephrology clinic at Althawra Central Teaching Hospital-Albida, Participants/patients: All patients withidiopathic nephrotic syndrome (INS)were evaluated during 2005- 2016. Patients divided into two groups, group I 46 (39%) is non-relapseand group II 72 (62.7%) is relapse group. Group II are sub divided into group A: frequent relapse steriod dependent (FRNS/SDNS)and group B:infrequent relapse nephrotic syndrome(IRNS). Results: Records of 118 children with INS were studied and 74 (62.7%) were boys, male to female ratio 1.7:1. There was no significance difference between group I and group II in the following parameters; age group, sex, family history, initial hypertension and hematuria(p value = >0.05). Mean proteinuria was significantly higher in group II (p 0.001), while mean s. albumin, mean s. cholesterol and mean blood urea did not show any significant difference statistically and p value were (0.022),(0.012),(0.116) respectively. Group B showed significant higher frequency than group A regardingsex(p=0.010), age group 1 and positive family history (p=0.050), both groups were comparable regarding gross hematuria and hypertension (p=0.975). Mean s albumin was significantly low in group A (p = 0.03) but no significance difference between both group regarding mean proteinuria, lipid profile and renal function and the p value for the three variables were (0.015) (0.206), (0.257) respectively. The most common complications were hypocalcemia, cushingoidfacies and obesity(26.5%, 25.4%, 18.6%) respectively, followed by infections (13.5%), hypertension (11.8%), acute kidneyinjury(8.4%), chronic kidney disease (1.7%) and death in onepatient (0.8%). Conclusions: Idioptic nephrotic syndrome is chronic relapsing disease for most steroid-responsive patients especially males between 2 -8 years with different complications of disease and its treartment affecting patient's life.

Keywords: Idiopathic nephrotic syndrome, Relapse, Steroid sensitive nephrotic syndrome, Steroid resistant nephrotic syndrome.