Nephrotic syndrome in South African children : changing perspectives over 20 years.
We review our 20-year experience of 636 children with nephrotic syndrome (NS) in Durban, South Africa ; 306 (48.2%) were blacks, 307 (48.2%) Indians and 23 (3.6%) were a mixed group (coloured) ; 91 (14.3%) could not be categorised and were excluded from the analysis.
In Indian children, 134 of 286 (46.8%) had biopsy-proven minimal change NS (MCNS) and 94.8% of these were steroid sensitive (SS) ; 60 (21%) had SSNS but without renal biopsy ; 59 (20.6%) had focal segmental glomerulosclerosis (FSGS), with only 4.4% of these being SS.
In blacks, membranous nephropathy accounted for 40% of cases ; 86.2% were associated with hepatitis B virus antigens.
Typical SSNS continues to be uncommon among blacks.
Only 14.4% had either biopsy-proven SS-MCNS or SSNS ; 32 had MCNS lesions on biopsy, but 18 were steroid resistant (SR) ; 67 of 236 (28.4%) had FSGS, all of whom were SR.
Among coloured patients, 5 of 23 (21.7%) had biopsy-proven SS-MCNS and or unbiopsied SSNS ; 10 (43.5%) had FSGS and 6 of 23 (26.1%) had membranous nephropathy.
Proliferative lesions were present in only 2 of 23 (8.6%) coloured patients and was uncommon in all population groups.
Overall mortality was 3.1%. In brief, this is the largest reported series of NS among children in Africa and shows a typical pattern in Indians, an unusual pattern of histological types in blacks and an intermediate picture in coloureds.
Mots-clés Pascal : Néphrotique syndrome, Incidence, Origine ethnique, Forme clinique, Sensibilité, Chimiothérapie, Corticostéroïde, Evolution, Complication, Etude statistique, Enfant, Homme, République Sud Africaine, Afrique, Appareil urinaire pathologie, Rein pathologie, Néphropathie glomérulaire
Mots-clés Pascal anglais : Nephrotic syndrome, Incidence, Ethnic origin, Clinical form, Sensitivity, Chemotherapy, Corticosteroid, Evolution, Complication, Statistical study, Child, Human, South Africa, Africa, Urinary system disease, Kidney disease, Glomerulonephritis
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0428369
Code Inist : 002B14A01. Création : 19/12/1997.