Alhassan Abdulaziz, Mohamed Waleed Z, Alhaymed Mohamed
Department of Nephrology, Dawmat Aljandal General Hospital, Dawmat Aljandal, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2013 Sep;24(5):1050-4. doi: 10.4103/1319-2442.118096.
To determine the patterns in children with nephrotic syndrome (NS) in our region, we retrospectively studied 25 nephrotic patients evaluated and followed-up in the hospitals of the Aljouf region in Saudi Arabia. The male to female ratio was 2:1. The incidence of idiopathic NS was two to six cases per 100,000 children/year, while the prevalence was 12 cases per 100,000 children. Five patients presented with hypertension, seven (28%) with respiratory tract infection, three (12%) with tender abdomen, two (8%) with gross hematuria, one (4%) with thrombosis of renal veins with seizure and shock and the remaining seven presented to the hospital without complications. Twenty-three (92%) patients were sensitive to the first steroid course and two (8%) patients were steroid resistant, and both of them proved to have focal segmental glomerulosclerosis (FSGS) on biopsy. Of those who responded, six (24%) patients remained in remission, while 17 (68%) patients became steroid dependant. Of those who were diagnosed as steroid dependent, three patients were biopsied and one of them was diagnosed as FSGS, while the remaining two had minimal change glomerulonephritis. Regarding steroid-dependent patient relapses, seven (41%) patients showed infrequent relapses and ten (59%) patients had frequent relapses. We conclude that the patterns of NS and the response to treatment observed in this study did not differ significantly from studies from other places in the world.
为了确定我们地区肾病综合征(NS)患儿的发病模式,我们回顾性研究了在沙特阿拉伯阿尔朱夫地区医院接受评估和随访的25例肾病患者。男女比例为2:1。特发性NS的发病率为每年每10万名儿童中有2至6例,患病率为每10万名儿童中有12例。5例患者出现高血压,7例(28%)出现呼吸道感染,3例(12%)出现腹部压痛,2例(8%)出现肉眼血尿,1例(4%)出现肾静脉血栓形成并伴有癫痫和休克,其余7例入院时无并发症。23例(92%)患者对首个类固醇疗程敏感,2例(8%)患者对类固醇耐药,活检显示这2例均为局灶节段性肾小球硬化(FSGS)。在有反应的患者中,6例(24%)病情缓解,17例(68%)患者出现类固醇依赖。在被诊断为类固醇依赖的患者中,3例接受了活检,其中1例被诊断为FSGS,其余2例为微小病变性肾小球肾炎。关于类固醇依赖患者的复发情况,7例(41%)患者复发不频繁,10例(59%)患者复发频繁。我们得出结论,本研究中观察到的NS发病模式和对治疗的反应与世界其他地区的研究没有显著差异。