Clinical Profile and Histopathological Spectrum 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,
from 30 June 2017 to 1 July 2019, over a period of 2 year.
Material 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.
Percutaneous renal biopsy was done under ultrasound guidance using
a combination of midazolam and ketamine for sedation and samples
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) findings were noted in 21
(32.3%) patients, minimal change disease (MCD) was found in 16
(24.6%) patients and mesangial proliferative pattern was present in 11
(16.9%) of patients. IgA nephropathy, membranous nephropathy (MN)
and membranoproliferative glomerulonephritis (MPGN) were 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.
Key Words: Histopathological pattern, Renal Biopsy, Steroid
Resistant Nephrotic Syndrome, Children.