Evaluation of Helicobacter pylori eradication on the course of childhood nephrotic syndrome and its response to treatment

Childhood nephrotic syndrome is a serious disease with the high risk of mortality. The prevalence worldwide is approximately 2 to 7 cases per 100,000 children. Hitherto, the patients are treatmed with steroid or immunosuppressive therapy and renal transplantation. However, many patients are steroid resistant and have a high risk of recurrence. The mutations in seven genes (NHPS1, NPHS2, CD2AP, PLCE1, ACTN4, TRPC6, INF2) have been implicated in different forms of nephrotic syndrome. Among them, two genes, NPHS1 and NPHS2, encoding for nephrin and podocin protein of the glomerular filtration barrier, have a particularly serious influence in almost of cases and steroid resistance in patients. So that, in the world there were a lot of researches conducted to identify gene mutations that related to disease manifestations and the response to treatment in the patients who have different genetic background. Mutations in NPHS1 and NPHS2 are considered the main cause of 75% cases with nephrotic syndrome. And NPHS2 mutations related to 40% cases with steroid resistance in patients. These results will help the doctors to have an effective treatment for the patients. However, in Vietnam no study has yet been done to detect gene mutations in patients with nephrotic syndrome. In this article, we summarize the research which have been published to give an overview of the genetic basis of causing and treatment for childhood nephrotic syndrome.

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High Steroid Sensitivity among Children with Nephrotic Syndrome in Southwestern Nigeria

International Journal of Nephrology ◽

10.1155/2014/350640 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Taiwo Augustina Ladapo ◽

Christopher Imokhuede Esezobor ◽

Foluso Ebun Lesi

Keyword(s):

Nephrotic Syndrome ◽

Idiopathic Nephrotic Syndrome ◽

Black Children ◽

Response To Treatment ◽

Southwestern Nigeria ◽

Childhood Nephrotic Syndrome ◽

Sensitivity Pattern ◽

Renal Histology ◽

Steroid Sensitivity ◽

Black Populations

Recent reports from both Caucasian and black populations suggest changes in steroid responsiveness of childhood nephrotic syndrome. This study was therefore undertaken to determine the features and steroid sensitivity pattern of a cohort of black children with nephrotic syndrome. Records of children managed for nephrotic syndrome from January 2008 to April 2013 were reviewed. Details including age, response to treatment, and renal histology were analysed. There were 108 children (median age: 5.9 years, peak: 1-2 years), 90.2% of whom had idiopathic nephrotic syndrome. Steroid sensitivity was 82.8% among children with idiopathic nephrotic syndrome but 75.9% overall. Median time to remission was 7 days. Median age was significantly lower in steroid sensitive compared with resistant patients. The predominant histologic finding in resistant cases was focal segmental glomerulosclerosis (53.3%). No cases of quartan malaria nephropathy or hepatitis B virus nephropathy were diagnosed. Overall mortality was 6.5%. In conclusion, unusually high steroid sensitivity is reported among a cohort of black children. This is likely attributable to the lower age structure of our cohort as well as possible changing epidemiology of some other childhood diseases. Surveillance of the epidemiology of childhood nephrotic syndrome and corresponding modifications in practice are therefore recommended.

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