Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa.

Autor:	Vester U; Helios Klinikum St Johannes, Duisburg, Germany., Fombah A; Medical Research Council, Fajara, Gambia., Hölscher M; University Children's Hospital, Kinderheilkunde II, University of Duisburg-Essen, Essen, Germany., Garba D; Medical Research Council, Fajara, Gambia., Tapgun M; Medical Research Council, Fajara, Gambia., N'Jai PC; Medical Research Council, Fajara, Gambia., Mendy P; Medical Research Council, Fajara, Gambia., Bass G; Medical Research Council, Fajara, Gambia., Muhammad AK; Medical Research Council, Fajara, Gambia., Anderson ST; Imperial College London, London, United Kingdom., Sanneh A; Medical Research Council, Fajara, Gambia., Onyeama C; Medical Research Council, Fajara, Gambia., Helmchen U; Kidney Pathology Registry, University Hospital Hamburg, Hamburg, Germany., Bojang K; Medical Research Council, Fajara, Gambia., Hoyer PF; University Children's Hospital, Kinderheilkunde II, University of Duisburg-Essen, Essen, Germany., Corrah T; Medical Research Council, Fajara, Gambia.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2022 Mar 21; Vol. 10, pp. 854719. Date of Electronic Publication: 2022 Mar 21 (Print Publication: 2022).
DOI:	10.3389/fped.2022.854719
Abstrakt:	In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids. Results: The median age was 14.9 years (range 1.8-52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Vester, Fombah, Hölscher, Garba, Tapgun, N‘Jai, Mendy, Bass, Muhammad, Anderson, Sanneh, Onyeama, Helmchen, Bojang, Hoyer and Corrah.)
Databáze:	MEDLINE
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