Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium
The epidemiological landscape of nephrotic syndrome (NS) in South Africa has changed drastically in the New Millennium. Although the pattern of disease in the 3 main non-Black racial groups (White, Indian, and Mixed race) mirror that seen in Western countries, Black African children show a pattern o...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-04-01
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| Series: | Kidney International Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024919300427 |
| _version_ | 1818136966557859840 |
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| author | Louansha Nandlal Thajasvarie Naicker Rajendra Bhimma |
| author_facet | Louansha Nandlal Thajasvarie Naicker Rajendra Bhimma |
| author_sort | Louansha Nandlal |
| collection | DOAJ |
| description | The epidemiological landscape of nephrotic syndrome (NS) in South Africa has changed drastically in the New Millennium. Although the pattern of disease in the 3 main non-Black racial groups (White, Indian, and Mixed race) mirror that seen in Western countries, Black African children show a pattern of disease that is at variance with these 3 racial groups. The incidence of infectious diseases, particularly hepatitis B virus associated nephropathy has sharply declined to being almost extinct in Black children in the New Millennium whereas HIV-related nephropathy surfaced. However, following the widespread use of anti-retroviral therapy, its incidence has also decreased dramatically. Focal segmental glomerulosclerosis (FSGS), which was once uncommon, has, in the New Millennium, emerged as one of the most challenging forms of NS across all racial groups, particularly in Black children. Although the introduction of calcineurin inhibitors, mycophenolate mofetil and monoclonal antibodies (e.g., rituximab) has improved the outcome of children with FSGS, the reponse in Black children is less than optimal, with those having single gene mutations being universally unresponsive to all forms of immunosuppression. Key Words: children, hepatitis B, HIV, nephrotic syndrome |
| first_indexed | 2024-12-11T09:48:48Z |
| format | Article |
| id | doaj.art-2c3306a605c040698705a20d76095f40 |
| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-12-11T09:48:48Z |
| publishDate | 2019-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-2c3306a605c040698705a20d76095f402022-12-22T01:12:28ZengElsevierKidney International Reports2468-02492019-04-0144522534Nephrotic Syndrome in South African Children: Changing Perspectives in the New MillenniumLouansha Nandlal0Thajasvarie Naicker1Rajendra Bhimma2Discipline of Optics and Imaging, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Correspondence: Louansha Nandlal, Discipline of Optics and Imaging, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4000, South Africa.Discipline of Optics and Imaging, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South AfricaDepartment of Paediatrics and Child Health, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South AfricaThe epidemiological landscape of nephrotic syndrome (NS) in South Africa has changed drastically in the New Millennium. Although the pattern of disease in the 3 main non-Black racial groups (White, Indian, and Mixed race) mirror that seen in Western countries, Black African children show a pattern of disease that is at variance with these 3 racial groups. The incidence of infectious diseases, particularly hepatitis B virus associated nephropathy has sharply declined to being almost extinct in Black children in the New Millennium whereas HIV-related nephropathy surfaced. However, following the widespread use of anti-retroviral therapy, its incidence has also decreased dramatically. Focal segmental glomerulosclerosis (FSGS), which was once uncommon, has, in the New Millennium, emerged as one of the most challenging forms of NS across all racial groups, particularly in Black children. Although the introduction of calcineurin inhibitors, mycophenolate mofetil and monoclonal antibodies (e.g., rituximab) has improved the outcome of children with FSGS, the reponse in Black children is less than optimal, with those having single gene mutations being universally unresponsive to all forms of immunosuppression. Key Words: children, hepatitis B, HIV, nephrotic syndromehttp://www.sciencedirect.com/science/article/pii/S2468024919300427 |
| spellingShingle | Louansha Nandlal Thajasvarie Naicker Rajendra Bhimma Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium Kidney International Reports |
| title | Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium |
| title_full | Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium |
| title_fullStr | Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium |
| title_full_unstemmed | Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium |
| title_short | Nephrotic Syndrome in South African Children: Changing Perspectives in the New Millennium |
| title_sort | nephrotic syndrome in south african children changing perspectives in the new millennium |
| url | http://www.sciencedirect.com/science/article/pii/S2468024919300427 |
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