Abstract
Introduction: Idiopathic nephrotic syndrome represents 25% to 30% of glomerulonephritis in adults. These glomerulonephritides are responsible of about the half of chronic kidney failure examined as well in United States as in Europe or Africa. The aim of this study was to determine the anatomoclinic, therapeutic and progression patterns of idiopathic nephritic syndrome in Dakar. Patients and Methods: It is a retrospective ten-year study in the nephrology department of Aristide Le Dantec Hospital. Patients with idiopathic nephrotic syndrome were included. We analyzed anatomoclinic, therapeutic and progression data of idiopathic nephrotic syndrome. Results: On 202 patients with nephrotic syndrome, 156 (77%) were primitive. The mean age was 29.7 ± 12 years with a sex ratio of 2.4. Edema was found in 98 patients (62.8%) and hypertension in 63 patients (40%). The mean proteinuria was 6.8 ± 4.8 g/24h. Histologic lesions found at renal biopsy were focal segmental glomerulosclerosis in 71 patients (45.5%), minimal change disease in 68 patients (43.5%) and membranous nephropathy in 8 patients (5%). 134 patients (85.8%) received steroids alone, 12 patients (7.6%) received cyclophosphamide and 4 patients (2.5%) azathioprine in association with steroids. 44 patients (28.2%) reached remission. The factors of poor prognosis were: age, above 40 years, proteinuria above 10 g/24h, existence of renal failure at admission, absence of use of steroids therapy. Conclusion: This study shows that idiopathic nephrotic syndrome is frequent in our country with a prevalence of 77%. The most common lesion found at the renal biopsy is the focal segmental glomerulosclerosis. Remission is found only in 28% which is very low. 33% of patients progress towards chronic kidney disease due to the lack of early diagnosis and the use of traditional medicine.
Highlights
Idiopathic nephrotic syndrome represents 25% to 30% of glomerulonephritis in adults
Idiopathic nephrotic syndrome (NS) is determined by a proteinuria higher than 3 g/24 hours associated with hypoalbuminemia, with no kidney inflammatory lesions or immune complex deposits
Evolution was favorable towards spontaneous remission, complete or partial, or unfavorable marked by absence of remission and by the occurrence of complications related to NS and the treatment
Summary
Idiopathic nephrotic syndrome represents 25% to 30% of glomerulonephritis in adults These glomerulonephritides are responsible of about the half of chronic kidney failure examined as well in United States as in Europe or Africa. Idiopathic nephrotic syndrome (NS) is determined by a proteinuria higher than 3 g/24 hours associated with hypoalbuminemia, with no kidney inflammatory lesions or immune complex deposits. It is a clinical translation of a podocyte injury and represents 25% to 30% of glomerulonephritis in adults [1]. The aim of this study was to determine the epidemiological, clinico-biological, histological, therapeutic and progression profiles of idiopathic NS in Dakar
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