Pathological profile of biopsied Egyptian children with primary nephrotic syndrome: 15-year single center experience

Bakr, Ashraf; Eid, Riham; Sarhan, Amr; Hammad, Ayman; El-Refaey, Ahmed M; Elmougy, Atef; Zedan, Mohamed M; Moustafa, Fatma; Abdelrahman, Ashraf

doi:10.1007/s40620-013-0032-1

Cited by 13 publications

(10 citation statements)

References 29 publications

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“…It is worth noting that, in this study, the proportion of MN in glomerular diseases increased from 6.1-18.6%, which was much higher than that of children in other countries [11,17,19,20] and higher than that reported by Nie et al, which showed that the proportion of children with membranous nephropathy in China increased from 3-7% [12]. The number of patients with MN in the United States has been decreasing year by year [20].…”

Section: Discussioncontrasting

confidence: 52%

The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019

Jiang

Rong

Zhao

et al. 2021

Preprint

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Background: This study aimed to investigate the clinical and pathological characteristics and the changes in glomerular diseases in 2403 pediatric renal biopsies from 1999 to 2019.Methods: Renal biopsies performed on children aged ≤18 years between 1999 and 2019 were analysed at our center. We analysed the clinical and histological characteristics, distribution of pediatric glomerular diseases with various clinical presentations, and changes in the glomerular disease patterns during the study period.Results: The most common primary glomerular disease was IgA nephropathy (IgAN) (24.3%), followed by minimal change disease (MCD) (15.3%) and membranous glomerulonephritis (MN) (13.1%). Henoch-Schonlein purpura nephritis (HSPN) (18.1%) and lupus nephritis (LN) (7.2%) were the most frequently recorded secondary glomerular diseases. Alport syndrome and thin basement membrane nephropathy (TBMN) were the most common inherited glomerular diseases, accounting for 1.2% and 0.6% of the total glomerular diseases in children, respectively. The number of boys with IgAN, MCD and IgM nephropathy (IgMN) was higher than that of girls, while the number of girls with MN and LN was higher than that of boys. The frequencies of MCD, MN, IgMN and endocapillary proliferative glomerulonephritis (EnPGN) in the 13-18-year-old group were higher than those in the 0-12-year-old group, while the frequencies of IgAN, mesangial proliferative glomerulonephritis (MsPGN) and focal proliferative glomerulonephritis (FPGN) were lower than those in the 0-12-year-old group. The ratio of Alport syndrome and TBMN in the 0-12-year-old group was higher than that in the 13-18-year-old group. The proportion of patients with MCD and MN in 2010-2019 was higher than that in 1999-2009, while the ratio of IgAN, MsPGN, IgMN, EnPGN, membranoproliferative glomerulonephritis (MPGN), HSPN and HBV-associated glomerulonephritis (HBV-GN) decreased. MCD (28.5%) was the most common cause of nephrotic syndrome (NS). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more common than other glomerular diseases. IgAN (39.4%) was the most common cause of AKI. Sclerosing glomerulonephritis (SGN) (21.1%) was the main cause of progressive chronic kidney disease (CKD).Conclusions: Glomerular diseases in children were related to sex and age. From 1999 to 2019, the spectrum of children's kidney disease in our center changed significantly.

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Section: Discussioncontrasting

confidence: 52%

The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019

Jiang

Rong

Zhao

et al. 2021

Preprint

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“…It is worth noting that, in this study, the proportion of MN in glomerular diseases increased from 6.1% to 18.6%, which was much higher than that of children in other countries [11,17,19,20] and higher than that reported by Nie et al, which showed that the proportion of children with membranous nephropathy in China increased from 3% to 7% [12]. The number of patients with MN in the United States has been decreasing year by year [20].…”

Section: Discussioncontrasting

confidence: 52%

“…In a cross-sectional study in China, MCD was considered to be the most common glomerular disease in children [12]. In Egypt and South Asia, MCD was reported to be the most common glomerular disease in children [11,17,18]. In Croatia and Italy, IgAN was reported to be the most common glomerular disease in children [10,14].…”

Section: Discussionmentioning

confidence: 99%

The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-proven Cases from a Single Centre in China between 1999 and 2019

Jiang

Zhao

Dou

et al. 2021

Preprint

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Background: This study aimed to investigate the clinical and pathological characteristics and the profile of and temporal changes in glomerular diseases in 2403 paediatric renal biopsies from 1999 to 2019.Methods: Renal biopsies performed on children aged ≤18 years between 1999 and 2019 were analysed at our centre. We analysed the clinical and histological characteristics, distribution of paediatric renal diseases with various clinical presentations, and changes in the pattern of kidney disease during the study period.Results: The most common primary glomerular disease was IgA nephropathy (IgAN) (24.3%), followed by minimal change disease (MCD) (15.3%) and membranous glomerulonephritis (MN) (13.1%). Henoch-Schonlein purpura nephritis (HSPN) (18.1%) and lupus nephritis (LN) (7.2%) were the most frequently recorded secondary glomerular diseases. Alport syndrome and thin basement membrane nephropathy (TBMN) were the most common inherited glomerular diseases, accounting for 1.2% and 0.6% of the total glomerular diseases in children, respectively. The number of boys with IgAN, MCD and IgM nephropathy (IgMN) was significantly higher than that of girls, while the number of girls with MN and LN was significantly higher than that of boys. The frequencies of MCD, MN, IgMN and endocapillary proliferative glomerulonephritis (EnPGN) in the 13-18-year-old group were significantly higher than those in the 0-12-year-old group, while the frequencies of IgAN, mesangial proliferative glomerulonephritis (MsPGN) and focal proliferative glomerulonephritis (FPGN) were lower than those in the 0-12-year-old group. The ratio of Alport syndrome and TBMN in the 0-12-year-old group was significantly higher than that in the 13-18-year-old group. The proportion of patients with MCD and MN in 2010-2019 was significantly higher than that in 1999-2009, while the ratio of IgAN, MsPGN, IgMN, EnPGN, membranoproliferative glomerulonephritis (MPGN), HSPN and HBV-associated glomerulonephritis (HBV-GN) decreased. MCD (28.5%) was the most common cause of nephrotic syndrome (NS). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more common than other glomerular diseases. IgAN (39.4%) was the most common cause of AKI. Sclerosing glomerulonephritis (SGN) (21.1%) was the main cause of progressive chronic kidney disease (CKD).Conclusions: Glomerular diseases in children were related to sex and age. From 1999 to 2019, the spectrum of children's kidney disease in our centre changed significantly.

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“…Histopathological patterns in some studies from other geographical locations are presented in (Table 2). [10][11][12][13][14][15] Arif et al 11 Absar et al 12 Bakr et al 13 Asinobi et al 14 Incidence of focal segmental glomerulosclerosis (FSGS) is observed to be increasing over the years in Pakistan. 11,12,15 Geographical variation seems to be significant contributors for the different histopathological findings of nephrotic syndrome in children.…”

Section: Resultsmentioning

confidence: 99%

Renal biopsy in children with nephrotic syndrome: a study of histopathological pattern

Joshi¹,

Joshi

2019

Int J Contemp Pediatr

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Background: Idiopathic nephrotic syndrome (INS) is a common childhood renal disease characterized by a remitting and relapsing course, associated with different histopathological subtypes. The true incidence of various histopathological subtypes of NS remains under estimated owing to the diversity in indication criteria for performing renal biopsies in pediatric population.Methods: This was a cross-sectional observational study in children with nephrotic syndrome at a tertiary health care centre. Total 22 children, with nephrotic syndrome, who underwent renal biopsy procedure during a period of one year, were enrolled for the study. Indications of renal biopsy were noted, and the histopathology reports were studied in detail.Results: In this study group, the most common indication for renal biopsy was “Atypical age (> 8years) of diagnosis in 45.5% (10/22) patients, followed by 22.7% (5/22) in “Children presenting with hypertension and hematuria”.The most common histopathological finding in these children was mesangial proliferative glomerulonephritis in 45.5% (10/22) patients followed by IgA nephropathy with mesangial proliferation in 22.72% (5/22) and minimal change disease in only 13.6% (3/22).Conclusions: This study highlights the occurrence of non-MCD as the common cause of INS in the children and denotes the significance of performing renal biopsies in children with INS for better prognostication.

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Pathological profile of biopsied Egyptian children with primary nephrotic syndrome: 15-year single center experience

Abstract: This is the first large study on the pathological pattern of PNS in children from Egypt, and it shows that MCD is the most frequent underlying pathology and steroid resistance is the most frequent indication for biopsy.

Cited by 13 publications

References 29 publications

The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019

The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019

The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-proven Cases from a Single Centre in China between 1999 and 2019

Renal biopsy in children with nephrotic syndrome: a study of histopathological pattern

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