scholarly journals Childhood nephrotic syndrome at the University of Abuja Teaching Hospital, Abuja, Nigeria: a preliminary report supports high steroid responsiveness

2019 ◽  
pp. 126-139
Author(s):  
Emmanuel Anigilaje ◽  
Andrew Fashie ◽  
Clement Ochi
2021 ◽  
Vol 5 (2) ◽  
pp. 067-076
Author(s):  
Faizan Mohammed K ◽  
McCracken Courtney ◽  
Lieberman Kenneth ◽  
Leong Traci ◽  
Benfield Mark R

Objective: We set up a U.S. registry to examine prescription patterns and patient outcomes of repository corticotropin injection (Acthar® Gel) for childhood nephrotic syndrome. Methods: 18 participating U.S. pediatric centers performed retrospective review and prospective observation of patients < 21 years old with nephrotic syndrome treated with Acthar Gel. We captured baseline characteristics, drug regimen and duration, and disease response following treatment. Results: 46 patients, enrolled from 2015 to 2020 were included. 27 (58.7%) were male. 18 patients (39.1%) had a diagnosis of minimal change followed by focal segmental glomerulosclerosis in 16 patients (34.7%). Median age at start of treatment was 12.5 years (IQR 8.5-17.4) compared to 5.3 years at diagnosis (IQR 2.7-10.5 years). 52% were resistant to corticosteroids. The most common Acthar Gel regimen was 80IU twice a week with a median duration of 199 days (IQR 88-365). Among 37 patients with active disease, 18 (49%) were able to achieve partial or complete remission, though all patients that had a positive response were on other immunosuppressants concomitantly. Conclusion: We report the findings of the largest registry cohort of pediatric patients in the U.S. treated with Acthar Gel for clinically challenging cases of nephrotic syndrome. Acthar Gel was successful in inducing remission in approximately half of the patients with active disease at time of treatment. No predictors of response with respect to demographic data, age at start of Acthar Gel therapy, etiology of nephrotic syndrome, presence or absence of comorbidities, or steroid responsiveness was noted.


2020 ◽  
Vol 15 (1) ◽  
pp. 5
Author(s):  
Vikas Agarwal ◽  
Harshit Singh ◽  
Narayan Prasad ◽  
DurgaPrasanna Misra ◽  
AkhileshKumar Jaiswal

2020 ◽  
Vol 7 (3) ◽  
pp. 439
Author(s):  
Pedro C. Emem Chioma ◽  
Friday S. Wokoma

Background: Adult nephrotic syndrome is a common cause of chronic kidney disease globally and in Sub-Saharan Africa.  In Nigeria there are only few studies on adult nephrotic syndrome, mostly from the south-western Nigeria and rarely from the Niger delta sub-region of Nigeria. This study aims at contributing to the National data on adult nephrotic syndrome, from the perspective of the Niger delta sub-region.Methods: Retrospective analysis of five-year clinical data (January 2007 to December 2011) of adult nephrotic syndrome patients in the University of Port Harcourt teaching hospital was conducted.Results: Forty-four patients, representing 1% of medical admissions and 7.3% of adult renal cases were seen during the period, with mean age of 27.7±8.5 years. There were 32 males (72.7%). Mean duration of illness was 25.3±30.3months. Peak age group was the 20-29 year age group, accounting for 52.3% of cases.  Hypertension was seen in 45.5%. Mean e-GFR was 73.5±33.8 ml/min/1.73m2 with CKD 1-3 constituting 93.2% of cases. Mean 24-hour urinary protein excretion was 13.6±8.4 grams/day. Protein excretion >10grams/day was observed in 65.8% of the patients.  Mean total serum protein, albumin and total cholesterol were 51.4±11.7g/dl, 22.5±9.9 g/dl and 8.1±3.0 mmol/L, respectively. Anemia was common (68%) and histology showed MCGN (52.6%), MCD (21.1%), membranous (15.8%) and FSGS (10.5%). Though response to therapy was generally poor, immunosuppressive therapy showed better outcomes.Conclusions: The prevalence and pattern of adult nephrotic syndrome in the Niger delta sub-region is similar to that in other parts of Nigeria.  It is predominantly a disease of young adult males with high prevalence of hypertension, and poor histologic categories.


2020 ◽  
Vol 5 (3) ◽  
pp. S196
Author(s):  
H. SINGH PhD ◽  
N. Prasad ◽  
A. Jaiswal ◽  
D. Misra ◽  
V. Agarwal

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