Nephrotic Syndrome: Epidemiological, Clinical, Paraclinical and Therapeutic Profile

Abstract

Background: End-stage kidney disease has several causes, including nephrotic syndrome (NS). Steroid- resistant nephrotic syndrome (SRNS) children are a difficult subset of nephrotic syndrome patients who frequently respond poorly to conventional immunosuppression. Objective: The goals of our research are to analyze the different types of nephrotic syndrome, to study the epidemiological, clinical and paraclinical profile, as well as to present the difficulty in managing steroid-resistant nephrotic syndrome. Methods: Our study is a cross-sectional analysis of all patients hospitalized or followed in consultation, who were diagnosed with a nephrotic syndrome at the pediatric B department of the university hospital center Mohamed VI in Marrakech, from January 2011 to January 2022. Results: We gathered 447 instances, with an annual incidence of 41 cases. The children's ages varied from 12 days to 16 years, with an average of 5 years and 9 months. Pure nephrotic syndrome was found in 302 patients and 145 patients were carriers of impure nephrotic syndrome. In our study, 81.5% of patients had nephrosis as the cause of deseas. Secondary NS was seen in 11% of the patients, infant form was found in 6% and 1.5% of cases were congenital. The treatment was mainly based on oral corticosteroid therapy. 71.4% of the patients were corticosensitive of which 45.3% became corticodependent while 28.6% of the cases were corticoresistant. Corticosteroid boluses were used in 53% of cases. Immunosuppressants were prescribed in 31.5% of patients. Conclusion: In children, nephrotic syndrome is a common and chronic illness. It is of particular interest because of the frequency of nephroses, multiple relapses, the difficulties of management and the psychological and school impact on the child.