Demographic, Clinical and Therapeutic Characteristics of Children Aged 0-15 years with Nephrotic Syndrome: A Retrospective Study of the Komfo Anokye Teaching Hospital, Kumasi, Ghana

Abstract

Background: Nephrotic syndrome is a common childhood renal disease globally with a penchant for the early years of life and has generated a lot of interest among paediatricians and nephrologists. Aim: This study aimed to determine the clinical, therapeutic and socio-demographic features of children with nephrotic syndrome at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Methodology: Hospital-based single-center study conducted from December 2015 to May 2016 among children with nephrotic syndrome at the Child Health Department of the Komfo Anokye Teaching Hospital (KATH) in the Ashanti Region of Ghana. Retrospective data of 172 patients admitted from January 2011 to January 2015 was used. Socio-demographic and laboratory data (biochemical and serological) of participants were retrieved from the laboratory database while clinical information (family history, past medical records, and symptoms) was retrieved from the patients’ records. Results: Of the 172 participants sampled, 112 (65.1%) were males and 60 (34.9%) were females. The mean ages of the males and the females were similar (6.56 ± 3.25 vs 6.80 ± 3.19; p = 0.647). Interestingly, majority of the males 49 (68.1%) and the females 23 (31.9%) were within the age group 4-7 years. Compared to females, more male participants had ascites [17 (81.0%) vs 4 (19.0%)], and bilateral nephromegaly [13 (76.5%) vs 4 (23.5%)]. On clinical examination, the commonest conditions among the males and the females were hypertension [44 (25.6%)] followed by glomerulonephritis [31 (18.0%)] and then infection [15 (8.7%)]. The least condition on clinical examination among the participants was hepatomegaly [2 (1.2%)] which was seen more in the males [2 (100%)] than the females. Participants presented with more generalized body swellings [122 (70.9%)], facial puffiness [105 (61.0%)], and symptoms of infection [101 (58.7%)]. Hematuria [3(1.7%)] was uncommon among the participants and was lower in the males [1(33.3%)] than the females [2(66.7%)]. Most participants had undetermined steroid response with males dominating. Males were more sensitive to steroids than females. Conclusion: Nephrotic syndrome was common among males aged 4-7 with low social class. Renal impairment, generalized body swelling, facial puffiness, symptoms of infection and hypertension were the commonest clinical manifestations. Males were more steroid sensitive than females.