Clinical and histopathological profile of adolescent onset idiopathic nephrotic syndrome in north Indian children

Abstract

Adolescent onset idiopathic nephrotic syndrome (INS) is marked by increased incidence atypical features and non-minimal change disease in histopathology. The objective of the study was to analyze the clinical features and histopathological spectrum of adolescent-onset INS. It was conducted in a Pediatric nephrology clinic of a tertiary care hospital in North India. We retrospectively evaluated clinical features, biochemical investigations and histopathology of 33 adolescents with idiopathic NS registered in pediatric nephrology clinic. Twenty-three (70.0%) adolescents had steroid resistant nephrotic syndrome. Hematuria was present in 39%, hypertension 36% and acute kidney injury (AKI) in 27%. Three-fourth of adolescents who underwent biopsy had non-minimal change disease in histopathology. Adolescent onset INS have increased incidence of AKI, hypertension, and non-minimal change disease. syndrome (NS) is different from that seen in young children1 as well as that seen in adults.2 Adolescent onset idiopathic NS (INS) may have increased incidence of acute kidney injury (AKI), hypertension, and nonminimal change disease. Historically, there has been no clear consensus on the indications of renal biopsy in adolescents who present with the INS. There is a need to define criteria for pretreatment biopsies in this age group. There are few published studies reporting clinicopathological profile of adolescent onset INS.3-6 We conducted a retrospective analysis of medical records of children with onset of NS during adolescent period. The objective of the study was to evaluate the clinical features, steroid responsiveness and histopathological spectrum of adolescent onset nephrotic syndrome.