Abstract

FERNANDEZ, Sara; CARRANZA, Alfonso  and  MADRIGAL, Gilbert. Síndrome nefrótico primario en niños de Costa Rica: Correlación clínico-patológica. Acta pediátr. costarric [online]. 2005, vol.19, n.2, pp.17-26. ISSN 1409-0090.

Introduction: Percutaneous renal biopsy have made posible to evaluate the renal histology and make clinico pathological correlations (ISKD). Methods: A retrospective analysis in two consecutive 5 years group A and group B review of all the renal biopsies perfomed at the Hospital Nacional de Niños of San José, Costa Rica, a 350 beds pediatric teaching hospital. Results: From a total of 81 cases, 14 ere excluded due to lack of complete information. From the 67 cases (group A and group B together) 37 (55%) were male and 30 (45%) were female (p less than 0.05). The age of patients with SRNS (steroid resistant nephritic syndrome) and with SDNS (steroid dependant nephritic syndrome) had a peak age (4.8 + 3.4 years old) older than usual peak age of the idiopatic nephritic syndrome in children. Of 31 patients with SRNS: 35% MGDGN (mild mesangial glomerulonephritis), 29% ML (minimal lesion), 29% FSGS and 6.5% MG (membranous glomerulonephiritis) (p less than 0.05). Of the 27 patients with SDNS 63% ML, 33% MDGN, 4% MG and none with. (p less than 0.05). The 2 patients with FRNS (frequently relapsing nephritic syndrome) both had ML. Among the clinical parameters hematuria was the most frequently found: 47% MDGN, 27% FSGS and 27% ML. (p less than 0.05). Abnormally elevated serum creatinine was rarely observed and it was only in 30% FSGS and 30% of ML. (p less than 0.05). Regarding response to treatment with oral cyclophosphamide only 35% of SRNS responde while 75% SDNS responded. (p less than 0.05). Response to cyclophosphamide and the type of histology was as follows: ML: 71% responded 59% for MDGN and 50% MG.

Keywords : Síndrome nefrótico idiopático; correlación anatomopatológica; esteroide resistente; esteroide dependiente; citotóxico sensible resistente.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )