Background

Recent reports from small studies in West Africa suggest that Black children may have high rate of steroid sensitivity nephrotic syndrome (SSNS) contrary to long held knowledge. Herein, we determined the proportion of children with idiopathic nephrotic syndrome (INS) who achieved complete remission with steroid therapy and identified factors associated with complete remission.

Methods

We reviewed the medical records of 241 children with INS in two centres in Lagos from 2010 to 2019. We extracted demographic data, clinical features, laboratory values at the time of diagnosis, and receipt and response to steroids and other immunosuppressants.

Results

The median (interquartile range) age at diagnosis of INS was 5.1 (3.0–8.7) years and boys were 60.2% of the study population. Children with SSNS made up 85.9% (n = 207) of the study cohort. Among those aged 0–5 years, 92.6%were SSNS compared with 69.2% in those aged 11–17 years at the time of diagnosis. In addition, the proportion of children with SSNS increased from 73.8% between year 2010 and 2012 to 88.4% afterwards. Also, children with SSNS had lower serum creatinine (0.44 vs 0.70; p<0.001) and higher estimated glomerular filtration rate (101 vs 74.3 ml/min/1.73 m²; p = 0.008) at the time of diagnosis than those with steroid resistant nephrotic syndrome (SRNS).

Conclusion

Among Black children in Lagos, the proportion with SSNS is comparable to proportions described in children of Asian and European descent. Furthermore, children with SSNS had lower serum creatinine and higher glomerular filtration rate than those with SRNS.

中文翻译：

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尼日利亚儿童肾病综合征流行病学的变化：一项横断面研究。

背景

来自西非小型研究的最新报告表明，与长期以来所掌握的知识相反，黑人儿童可能有较高的类固醇敏感性肾病综合征（SSNS）。本文中，我们确定了通过类固醇疗法完全缓解的特发性肾病综合征（INS）儿童的比例，并确定了与完全缓解相关的因素。

方法

我们回顾了2010年至2019年在拉各斯两个中心的241例INS儿童的病历。我们提取了人口统计学数据，临床特征，诊断时的实验室值以及对类固醇和其他免疫抑制剂的接受和反应。

结果

INS诊断时的中位年龄（四分位间距）为5.1（3.0-8.7）岁，男孩为研究人群的60.2％。SSNS儿童占研究队列的85.9％（n = 207）。在0-5岁的人群中，SSNS为92.6％，而在诊断时为11-17岁的人群为69.2％。此外，SSNS儿童的比例从2010年至2012年的73.8％增加到此后的88.4％。此外，SSNS患儿在诊断时的血清肌酐水平较低（0.44 vs 0.70； p <0.001），估计的肾小球滤过率较高（101 vs 74.3 ml / min / 1.73 m ²； p = 0.008），比那些对类固醇耐药的儿童高。肾病综合征（SRNS）。

结论

在拉各斯的黑人儿童中，SSNS的比例与亚洲和欧洲血统的儿童中描述的比例相当。此外，SSNS患儿的血清肌酐和肾小球滤过率均高于SRNS患儿。