ESPN 51th Annual Meeting

ESPN 2018


 
Hypertension in pediatric idiopathic nephrotic syndrome: is it an indicator of poor prognosis?
SARA ABULSEOUD MAHMOUD EL-KERSH HANAN FATHY 1

1- ALEXANDRIA UNIVERSITY
 
Introduction:

The incidence of hypertension in pediatric idiopathic nephrotic syndrome (INS) varies from 11% to 26.8%. It indicates major pathological changes in the kidney. We aimed to study the prognosis of INS complicated by hypertension.

Material and methods:

We reviewed the files of 181 child (2010-2014) who had INS. Patients were classified into 2 groups, G1, 133 (73.5%) child without and G2, 48 (26.5%) child with hypertension. Renal biopsy was done in 34 patients who suffered frequent relapse or steroid resistance. Steroid responsive were considered as MCNS.

Results:

Mean age at onset was 4.48±2.30, and 4.49±3.08 years, male to female ratio was 2.6:1 and 2.7:1, microscopic hematuria occurred in 9% Vs 20.8% (p=0.006) and gross hematuria in 1.5% Vs 8.3% (p=0.006), for G1 and G2 respectively. Steroid resistance occurred in 2.3% Vs 27.1% (p=0.001), and steroid dependance in 9.8% Vs 22.9% (p=0.021) for G1 and G2 respectively. G1 had higher incidence of long lasting remission 38.3% Vs 8.3% (p= 0.001). End stage renal failure occured in 3 patients of G2. MesPGN occurred in 1 (0.8%) patient and 12 (25%) patients , FSGS in 1 (0.8%) patient and 9 (18.8%) in G1 and G2 respectively (p=0.001). MPGN in 2 (1.5%) patients in G1 and 3 (6.3%) patients in G2 but without significant difference. MCNS was frequent in G1 (p=0.001).

Conclusions:

The presence of hypertension indicates a poor prognosis in INS and proper management is required to avoid bad sequlae.