O-29 The histopathology of steroid resistant nephrotic syndrome at the Bustamante Hospital for Children and the University of the West Indies.
Author(s):
D Clayton, , R Thomas-Chen , L Gabay , S Young Peart,
Year of Presentation:
2022
Objective: This study aims to document the histopathological lesions and risk factors associated with steroid resistant
nephrotic syndrome (SRNS) in Jamaican children. In view
of the difficulties managing SRNS, we aim to determine
if there is a change in the most common histopathological
lesion found in SRNS to focal segmental glomerulosclerosis
(FSGS).
Methods: This was a retrospective, descriptive study of children = 12 years diagnosed with nephrotic syndrome and presenting for management at the Bustamante Hospital for Children and the University Hospital of the West Indies between January 1, 2009, to December 31, 2019. The data was collected using a data extraction sheet. The Pearson’s chi square test was used to compare proportions. A p value < 0.05 is considered statistically significant.
Results: Fifty-one children were available for review. The mean age was 4.41 ± 3.3yrs with a male to female ratio of 1.2:1. A renal biopsy was indicated for 87.8% of the patients. SRNS accounted for 66.7% percent. Overall, MCD was the most common histopathological lesion and FSGS was the most common in SRNS. Gross haematuria, hypertension and renal impairment were among the identified risk factors.
Conclusion: FSGS was the most common lesion in patients with SRNS. FSGS has an increased risk of progression to ESRD and due to its debilitating effects, plans must be put in place to manage not only these children in their current conditions but also to incorporate future planning for genetic testing and possible dialysis and renal transplantation.