Spectrum of renal pathology in 100 selected children with nephrotic syndrome.

The study includes 100 renal biopsies from an equal number of patients referred to us with nephrotic syndrome (NS). Their ages ranged from one month to 13 years (medial five years) and included 59 males and 41 females. Indications for kidney biopsy were steroid resistance in 41 patients, steroid dependence with frequent relapses on maintenance steroid therapy in 38, NS associated with gross hematuria, hypertension, azotemia, and/or systemic manifestations in eight and age of less than one year at the onset of the disease in 13 patients. In 90 patients, NS was idiopathic in origin and in eight, it was secondary to IgA nephropathy, hemolytic-uremic syndrome, post streptococcal glomerulonephritis, antiglomerular basement membrane antibodies, Henoch-Schonlein nephritis and systemic lupus erythematosus. Two patients had hepatitis B infection and its relationship with NS could not be elucidated. Primary NS is the predominan type of NS in the local pediatric population. The disease in more common in the first year of life. A relatively high incidence of diffuse mesangioproliferative glomerulonephritis (MesPGN) and rarity of infection-related NS are noted.