Response to corticosteroid treatment in paediatric nephrotic syndrome: A retrospective review from Mozambique

Background. First-line treatment for paediatric nephrotic syndrome, a chronic disease characterised by proteinuria, hypoalbuminaemia and oedema, is corticosteroid therapy. An association between African ethnicity steroid resistance has been reported, but published data from sub-Saharan Africa are limited lack consensus on the prevalence of steroid-resistant disease. Objective. We aimed to describe cohort patients with determine frequency resistance, investigate factors associated at Hospital Central de Maputo, Mozambique. Methods. A retrospective chart review was performed (1 - 14 years old) admitted syndrome 2010 2015 least one follow-up visit 31 March 2016. Patients HIV or malaria were excluded. Descriptive statistics frequencies disaggregated response produced. Associations sociodemographic, clinical laboratory variables investigated appropriate univariable statistical tests. Results. Twenty-eight met inclusion criteria as having steroid-sensitive based an initial regimen. There 15 boys (53.6%) 13 girls (46.4%), median age 5.5 years. Fifteen steroid-sensitive, (46.4%) steroid-resistant. Steroid-resistant had significantly lower diastolic blood pressure ( p =0.004), serum haemoglobin =0.003), albumin =0.03) higher platelet counts =0.008) compared sensitive cases. Only 4 (30.8%) received kidney biopsy. Conclusion. Given relatively high occurrence in this study, expanding access biopsy second-line medications not remission after course therapy needed meet current standard care. Factors need be studied prospectively larger cohorts Mozambican children.