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Pediatric Nephrotic Syndrome in a Cameroonian Cohorte: The Beast to Slaughter

DOI: 10.4236/ojneph.2024.143036, PP. 386-396

Keywords: Idiopathic Nephrotic Syndrome, Outcome, Mortality, End-Stage Kidney Disease, Children, Cameroon

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Abstract:

Background: Idiopathic nephrotic syndrome (INS) is a frequent pathology in children. There is little data on the future of NS in children in sub-Saharan Africa, particularly Cameroon. The aim of our study is to report the prognosis of children treated for nephrotic syndrome in the city of Yaoundé. Method: This was an analytical cross-sectional study with retrospective collection in 4 reference hospitals in the Cameroonian capital over a period of five years from January 1, 2018 to December 31, 2022. We included all medical records of patients treated for idiopathic INS. We excluded incomplete records and those with a history of chronic kidney disease. The sociodemographic, clinical, paraclinical, and therapeutic data, as well as the short-term evolution were collected in the files. Data was analysed using the software statistical package for social sciences version 25.0. Statistical significance was set at a p-value <0.05. Results: A total of 131 children (58% boys) were included in our study over a period of 5 years. The median age was 8 [6 - 11] years. Median proteinuria was 5 g/24h [3 - 8.4], median serum protein was 39 [34 - 46] g/l and median estimated glomerular filtration rate was 130.36 [68 - 174.6] ml/min/1.73m2. During steroid therapy, 45.07% were in partial remission at 2 months, 16.9% were in complete remission at 4 and 6 months, and 37.25% had relapsed. Steroid sensitivity was reported in 28.17% of cases, steroid resistance in 64.78% of cases and steroid dependent in 7.04% of cases. The mortality rate was 12.97%. Survival time averaged 48.2 months, with an overall crude survival rate of 99.2% at 3 and 6 months and 98.4% at 1 year. Regarding renal survival, renal function was impaired in 8.33% of patients at 6 months and 9% at 12 months. Conclusion: Idiopathic nephrotic syndrome is a common disease in children. Its evolution depends on corticosteroid therapy. The long-term prognosis is dominated by the risk of progression to end-stage kidney disease or even death. Rigorous and affordable follow-up is essential to reduce the number of patients lost to follow-up and the occurrence of complications.

References

[1]  Ademola, A.D., Asinobi, A.O., Alao, M.A. and Olowu, W.A. (2022) Childhood Nephrotic Syndrome in Africa: Epidemiology, Treatment Trends, and Outcomes. Seminars in Nephrology, 42, Article ID: 151311.
https://doi.org/10.1016/j.semnephrol.2023.151311
[2]  Esezobor, C., Ademola, A.D., Adetunji, A.E., Anigilaje, E.A., Batte, A., Jiya-Bello, F.N., et al. (2021) Management of Idiopathic Childhood Nephrotic Syndrome in Sub-Saharan Africa: Ibadan Consensus Statement. Kidney International, 99, 59-67.
https://doi.org/10.1016/j.kint.2020.07.045
[3]  Doe, J.Y., Funk, M., Mengel, M., Doehring, E. and Ehrich, J.H.H. (2005) Nephrotic Syndrome in African Children: Lack of Evidence for ‘Tropical Nephrotic Syndrome’? Nephrology Dialysis Transplantation, 21, 672-676.
https://doi.org/10.1093/ndt/gfi297
[4]  Nandlal, L., Naicker, T. and Bhimma, R. (2019) Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium. Kidney International Reports, 4, 522-534.
https://doi.org/10.1016/j.ekir.2019.01.019
[5]  Esezobor, C.I., Solarin, A.U. and Gbadegesin, R. (2020) Changing Epidemiology of Nephrotic Syndrome in Nigerian Children: A Cross-Sectional Study. PLOS ONE, 15, e0239300.
https://doi.org/10.1371/journal.pone.0239300
[6]  Olowu, W.A., Ademola, A., Ajite, A.B. and Saad, Y.M. (2017) Childhood Nephrotic Syndrome in Tropical Africa: Then and Now. Paediatrics and International Child Health, 37, 259-268.
https://doi.org/10.1080/20469047.2017.1374002
[7]  Anochie, I., Eke, F. and Okpere, A. (2006) Childhood Nephrotic Syndrome: Change in Pattern and Response to Steroids. Journal of the National Medical Association, 98, 1977-1981.
[8]  Halle, M.P., Lapsap, C.T., Barla, E., Fouda, H., Djantio, H., Moudze, B.K., et al. (2017) Epidemiology and Outcomes of Children with Renal Failure in the Pediatric Ward of a Tertiary Hospital in Cameroon. BMC Pediatrics, 17, Article No. 202.
https://doi.org/10.1186/s12887-017-0955-0
[9]  Hermine, F.M., Mahamat, M., Jessica, Y.A., Vic-torine, N., et al. (2021) Clinical Profile and Prognosis of Steroid Resistant Nephrotic Syndrome in Cameroon: A Single Centre Experience. Journal of Nephrology & Therapeutics, 11, 1-6.
[10]  Muhari-Stark, E. and Burckart, G.J. (2018) Glomerular Filtration Rate Estimation Formulas for Pediatric and Neonatal Use. The Journal of Pediatric Pharmacology and Therapeutics, 23, 424-431.
https://doi.org/10.5863/1551-6776-23.6.424
[11]  Keita, Y., Lemrabott, A.T., Sylla, A., Niang, B., Fary, E.H., Dial, C.M., et al. (2017) Le syndrome néphrotique idiopathique (SNI) de l’enfant à Dakar: À propos de 40 cas. Pan African Medical Journal, 26, Article No. 161.
https://doi.org/10.11604/pamj.2017.26.161.10130
[12]  Okoronkwo, N.C., Ibeneme, C.A., Ezuruike, E.O. and Nwala, G.C. (2014) Childhood Nephrotic Syndrome as Seen at the Federal Medical Centre, Umuahia, Nigeria. African Journal of Paediatric Nephrology, 1, 62-66.
[13]  Asinobi, A., Ademola, A. and Ogunkunle, O. (2019) Steroid Response in Primary Childhood Nephrotic Syndrome in a Tropical African Environment. Nigerian Journal of Clinical Practice, 22, 790-795.
https://doi.org/10.4103/njcp.njcp_206_16
[14]  Wine, R., Vasilevska-Ristovska, J., Banh, T., Knott, J., Noone, D., Gbadegesin, R., et al. (2021) Trends in the Epidemiology of Childhood Nephrotic Syndrome in Africa: A Systematic Review. Global Epidemiology, 3, Article ID: 100061.
https://doi.org/10.1016/j.gloepi.2021.100061
[15]  Couderc, A., Bérard, E., Guigonis, V., Vrillon, I., Hogan, J., Audard, V., et al. (2017) Traitements du syndrome néphrotique cortico-dépendant de l’enfant. Archives de Pédiatrie, 24, 1312-1320.
https://doi.org/10.1016/j.arcped.2017.09.002
[16]  Doumbia, A.K., Simaga, T., Dembélé, A., Baldé, M.S., Diall, H.G., Togo, P., et al. (2022) Childhood Idiopathic Nephrotic Syndrome: A Single-Center Hospital Study. Open Journal of Pediatrics, 12, 832-840.
https://doi.org/10.4236/ojped.2022.125084
[17]  Harambat, J., Ernould, S., Llanas, B. and Leroy, S. (2010) P285—Prédiction du recours aux immunosuppresseurs chez l’enfant néphrotique (SN) cortico-dépendant. Archives de Pédiatrie, 17, 121-122.
https://doi.org/10.1016/s0929-693x(10)70683-7
[18]  Banh, T.H.M., Hussain-Shamsy, N., Patel, V., Vasilevska-Ristovska, J., Borges, K., Sibbald, C., et al. (2016) Ethnic Differences in Incidence and Outcomes of Childhood Nephrotic Syndrome. Clinical Journal of the American Society of Nephrology, 11, 1760-1768.
https://doi.org/10.2215/cjn.00380116
[19]  Asinobi, A.O., Ademola, A.D., Ogunkunle, O.O. and Mott, S.A. (2014) Paediatric End-Stage Renal Disease in a Tertiary Hospital in South West Nigeria. BMC Nephrology, 15, Article No. 25.
https://doi.org/10.1186/1471-2369-15-25
[20]  Chemli, J. and Harbi, A. (2009) Traitement du syndrome néphrotique idiopathique corticorésistant. Archives de Pédiatrie, 16, 260-268.
https://doi.org/10.1016/j.arcped.2008.11.018
[21]  Carter, S.A., Mistry, S., Fitzpatrick, J., Banh, T., Hebert, D., Langlois, V., et al. (2020) Prediction of Short-and Long-Term Outcomes in Childhood Nephrotic Syndrome. Kidney International Reports, 5, 426-434.
https://doi.org/10.1016/j.ekir.2019.12.015
[22]  Olowu, W.A., Adelusola, K.A. and Adefehinti, O. (2010) Childhood Idiopathic Steroid Resistant Nephrotic Syndrome in Southwestern Nigeria. Saudi Journal of Kidney Diseases and Transplantation, 21, 979-990.

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