Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa
In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young a...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.854719/full |
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| author | Udo Vester Augustin Fombah Maite Hölscher Danlami Garba Mary Tapgun Pamela Collier N‘Jai Philipp Mendy Gibril Bass Abdul K. Muhammad Suzanne T. Anderson Abdoulie Sanneh Charles Onyeama Udo Helmchen Khalifa Bojang Peter F. Hoyer Tumani Corrah |
| author_facet | Udo Vester Augustin Fombah Maite Hölscher Danlami Garba Mary Tapgun Pamela Collier N‘Jai Philipp Mendy Gibril Bass Abdul K. Muhammad Suzanne T. Anderson Abdoulie Sanneh Charles Onyeama Udo Helmchen Khalifa Bojang Peter F. Hoyer Tumani Corrah |
| author_sort | Udo Vester |
| collection | DOAJ |
| description | In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases. |
| first_indexed | 2024-12-13T19:58:04Z |
| format | Article |
| id | doaj.art-31bb26a7a18c47fcb4e740b9dc80ddac |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-13T19:58:04Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-31bb26a7a18c47fcb4e740b9dc80ddac2022-12-21T23:33:16ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-03-011010.3389/fped.2022.854719854719Etiology of Kidney Diseases With Proteinuria in the Gambia/West AfricaUdo Vester0Augustin Fombah1Maite Hölscher2Danlami Garba3Mary Tapgun4Pamela Collier N‘Jai5Philipp Mendy6Gibril Bass7Abdul K. Muhammad8Suzanne T. Anderson9Abdoulie Sanneh10Charles Onyeama11Udo Helmchen12Khalifa Bojang13Peter F. Hoyer14Tumani Corrah15Helios Klinikum St Johannes, Duisburg, GermanyMedical Research Council, Fajara, GambiaUniversity Children's Hospital, Kinderheilkunde II, University of Duisburg-Essen, Essen, GermanyMedical Research Council, Fajara, GambiaMedical Research Council, Fajara, GambiaMedical Research Council, Fajara, GambiaMedical Research Council, Fajara, GambiaMedical Research Council, Fajara, GambiaMedical Research Council, Fajara, GambiaImperial College London, London, United KingdomMedical Research Council, Fajara, GambiaMedical Research Council, Fajara, GambiaKidney Pathology Registry, University Hospital Hamburg, Hamburg, GermanyMedical Research Council, Fajara, GambiaUniversity Children's Hospital, Kinderheilkunde II, University of Duisburg-Essen, Essen, GermanyMedical Research Council, Fajara, GambiaIn West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases.https://www.frontiersin.org/articles/10.3389/fped.2022.854719/fullkidneyproteinuria—nephrotic syndromekidney biopsyhistologyWest Africa |
| spellingShingle | Udo Vester Augustin Fombah Maite Hölscher Danlami Garba Mary Tapgun Pamela Collier N‘Jai Philipp Mendy Gibril Bass Abdul K. Muhammad Suzanne T. Anderson Abdoulie Sanneh Charles Onyeama Udo Helmchen Khalifa Bojang Peter F. Hoyer Tumani Corrah Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa Frontiers in Pediatrics kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa |
| title | Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa |
| title_full | Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa |
| title_fullStr | Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa |
| title_full_unstemmed | Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa |
| title_short | Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa |
| title_sort | etiology of kidney diseases with proteinuria in the gambia west africa |
| topic | kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.854719/full |
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