The Clinical Profile and Renal Biopsy Findings in Children with Steroid Resistant Nephrotic Syndrome

Abstract

Objective: To determine the frequency of different histopathological subtypes based on renal biopsy in children presenting with steroid resistant nephrotic syndrome (SRNS).

Study Design: Descriptive study

Place and Duration of Study: Department of Pediatric Medicine, Rawalpindi Medical University and Allied Hospitals Rawalpindi, over a period of 2 year.

Materials and Methods: Sixty five children of SRNS who fulfilled the inclusion criteria were enrolled in the study. Informed consent and demographic information was taken from all the patients. Per cutaneous renal biopsy was done under ultrasound guidance using a combination of midazolam and ketamine for sedation and sample were sent for histopathology.

Results: The mean age of patients was 8.10±2.70 years. Thirty seven (56.9%) patients were male and 28 (43.1 %) patients were females. Male to female ratio of the patients was found to be 1.32: 1.  Mean duration of disease at time of admission was 4.62±3.18 months. Focal segmental Glomerulosclerosis (FSGS) finding was noted in 21 (32.3%) patients, Minimal change disease (MCD) was found in 16 (24.6%) patients, Mesangial proliferative pattern was present in 11 (16.9%) of patients. IgA nephropathy, Membranous Nephropathy (MN) and Membranoproliferative (MPGN) ware found in 8 (12.3 %), 5 (7.7 %) and 4 (6.2 %) patients respectively.

Conclusion: The most common histopathological subtypes based on renal biopsy were FSGS and MCD in children presenting with SRNS.