Childhood nephrotic syndrome in Northern Nigeria: management and follow-up of 40 patients.

Abstract

While significant progress has been made in the search for suitable treatment of idiopathic minimum lesion nephrotic syndrome (IMLNS) which is by far the commonest form of childhood nephrosis encountered in temperate countries little progress has been made in the treatment of non-IMLNS groups of nephrosis which form the preponderance of cases in East and West Africa. A report of management a follow up of 40 children with nephrotic syndrome is presented here. The children received uniform conservative treatment consisting of salt restriction furosemide chloroquine proguanil and high protein diet in the absence of azotemia. No child was treated with corticosteroids. During the 1st admission 2 patients died and 4 had complete remission at discharge. 3 of those children in complete remission belonged to the membranoproliferative group and 1 belonged to the proliferative glomerulonephritis group. The latter remained in complete remission throughout the 12 months of follow-up. At 6 months 4 children were in complete remission but 2 of the 3 with membranoproliferative glomerulonephritis and previously in complete remission had relapsed. At 13 months 6 children were in complete remission while 4 had died. Lack of remission and relapses were common.