HISTOPATHOLOGICAL PATTERN OF STERIOD RESISTANCE NEPHROTIC SYNDROME IN SUDANESE CHILDREN

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Abstract Title *

HISTOPATHOLOGICAL PATTERN OF STERIOD RESISTANCE NEPHROTIC SYNDROME IN SUDANESE CHILDREN

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Co-author 1

Nahla Allam allamnahla@yahoo.com Nora Center (Pediatric Renal Unit), soba university hospital .assistance professor Al -Neelain university ,faculty of medicine pediatric neprlogy khartoum Sudan *

Co-author 2

Fatima Ali dr.fatima.aldood@gmail.com -pediatric residence ,Nora Center (Pediatric Renal Unit), soba university hospital pediatric nephrology khartoum Sudan -

Co-author 3

El-Tigani MA Al allamnahla@yahoo.com Nora Center (Pediatric Renal Unit), Nephrology Division, Soba University Hospital, U of K pediatric khartoum Sudan -

Co-author 4

Yasir Mahgoup allamnahla@yahoo.com Nora Center (Pediatric Renal Unit), Nephrology Division, Soba University Hospital, U of K pediatric khartoum Sudan -

Co-author 5

, Rasha Hussain rasha9-9@hotmail.com Nora Center (Pediatric Renal Unit), Nephrology Division, Soba University Hospital, U of K pediatric nephrology khartoum Sudan -

Co-author 6

Nadia Aldaw rasha9-9@hotmail.com - Department of Pathology, Soba University Hospital. pathology khartoum Sudan -

Co-author 7

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Introduction

Managing Steroid-resistant nephrotic syndrome in children is particularly difficult as it often requires a step wise and individualized approach with out proper intervention the condition may progress to end stage renal disease. Renal biopsy play a key role in confirming the diagnosis and identify histological subtypes such as focal segmental glomerulosclerosis and minimal change disease. Which help guide treatment .

Objective: To characterized , the Histological pattern of Steroid-Resistant Nephrotic Syndrome among children in nephrology unit at soba university hospital 2022

Methods

This study is a retrospective study of medical records of pediatric patients with Steroid-Resistant Nephrotic Syndrome was at nephrology unit at soba university hospital in Khartoum Sudan, during the period from 2017 to 2021.

Results

A total of 62 patients were diagnosed with Steroid-Resistant Nephrotic Syndrome(SRNS) , of whom 30.6% were females . The most frequent initial presentation was generalized odema and high blood pressure .Focal Segmental Glomerulo Sclerosis (FSGS)was the predominant histopathological finding ,identified in 43.5% of cases .,while Minimal Change Disease (MCD) was more commonly observed in small children, positive family history was reported in 8% of participants . Angiotensin Converting Enzyme Inhibitors (ACEIs) were the most frequently prescribed adjunct therapy with prednisolone.

Over all 90.5% exhibited a favorable prognosis, defined by sustain remission ,stable renal function and absence of progression to end stage renal disease during follow up period

Conclusion

SRNS in Sudanese children demonstrate variable clinical and histological patterns with FSGS being the most frequent lesion .Al though many patients achieved good out comes the risk of progression to ESRD persist .These finding emphasized the importance of indidual treatment and need for further research in genetics ,immunological and pattern mechanism steroid resistance.

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