ABSTRACT
Background: Nephrocalcinosis is rare in children. Its etiologies are multiple. The aim of this study was to analyze the etiology of nephrocalcinosis in Tunisian children
Methods: This retrospective study was conducted in the department of pediatrics in Charles Nicolle Hospital during a period of 10 years [2001-2010]
Results: There were 40 children. The mean age was 3.5 years. The most common signs and symptoms at presentation were growth retardation [42.5%] and hematuria [53.8%]. At presentation, renal failure was detected in 70% of patients. The diagnosis of nephrocalcinosis was performed by ultrasonography. The etiology of nephrocalcinosis included primary hyperoxaluria type 1 [65%] and distal renal tubular acidosis [20%]. A progression to renal insufficiency was observed in 18 cases
Conclusion: Primary oxaluria is the principal cause of nephrocalcinosis; early diagnosis and treatment are mandatory as they help limiting renal function deterioration
ABSTRACT
Background: Focal segmental glomerulosclerosis [FSGS] represents 20% of nephrotic syndrome in children. The clinical course and prognosis is heterogeneous in children. The aim of this study was to analyze treatment and outcome of children with FSGS
Methods: This retrospective study was conducted in the Department of Pediatrics in Charles Nicolle Hospital during a 15-year period [1996-2010]
Results: There were 30 children, 16 boys and 14 girls. The mean age was 7 +/- 4 years. Nephrotic syndrome was observed in 26 patients, hematuria was noticed in 2 patients and renal insufficiency was detected in 2 patients at presentation. FSGS, not otherwise specified, was the predominant variant. All patients with nephrotic syndrome were treated with steroids. Only three patients responded to it. Twenty one patients were treated with cisclosporin A and this resulted in a 57% complete remission and a 24% partial response. Cyclophosphamide was administered to 6 patients and engendered a 50% complete remission. Six patients were treated with mycophenolate mophetil and showed no response in all cases. Renal insufficiency has been developed in 12 children
Conclusion: Results from this study showed that the majority of children with FSGS achieve a high sustained remission rate with ciclosporine A
ABSTRACT
Introduction: Peritoneal dialysis [PD] is still the most common modality used in treatment for children with End Stage Renal Disease [ESRD]. The objective of this study was to identify the epidemiological, clinical, and microbiological factors affecting the outcome of PD
Methods: In this study, we retrospectively reviewed the records of 85 patients who were treated with DP for the last ten years [from January 2004 to December 2013] in the Department of Pediatrics in Charles Nicolle hospital, Tunis
Results: The mean duration of PD was 18.1 +/- 12 months [3.5-75 months]. The average age of PD onset was 9.3 +/- 5.7 years [29 days-23 years]. The sex ratio was 1.5. In a significant number of cases with ESRD, the primary cause is Congenital Anomalies of the Kidneys and Urinary Tract [CAKUT]. Seventy-four of our patients [87%] had been treated with Automated PD. The average time between catheter placement and PD commencement was 3.9 +/- 4.6 days. Catheter change was 1.62 [1-5]. Sixty-one patients [71.8%] had experienced at least one episode of peritonitis. The most frequently isolated organisms was the Gram-positive bacteria [61%]. Survival rates without peritonitis at 12th, 24th and 36th months were 40%, 32% and 18%, respectively. Transition to permanent hemodialysis was required in 66% of patients
Conclusion: Considering the important incidence of peritonitis in our patients, it is imperative to establish a targeted primary prevention
ABSTRACT
To describe epidemiological, clinical, histological aspects, treatment and outcome of Henoch-Sch"nlein nephrits in children. A retrospective study was conducted on medical data of 34 patients with Henoch-Sch"nlein nephritis From January 1, 1996 to December 31, 2010 in the Pediatric Department of Charles Nicolle Hospital. Nephritis occured in 68,7%. The average patient age was 7 years 2 months and sex ratio was 0,6. Microscopic hematuria was noted in 23,5%, moderate proteinuria with or without hematuria was observed in 20,5%. Nephrotic syndrome was noted in 29,5%; nephritic syndrome was associated to nephritic syndrome in 23,5%. Isolated hypertension was noted in one patient. Follow-up was 2 years 6 months. Remission was noted in 26 cases [76,4%], minor urinary abnormalities in 7 cases [20,5%] and renal active disease in one case. Relapse was observed in 6 cases. Our study was characterized by the predominance of severe renal manifestations and low grade histological aspects as well as favourable outcome in most 90% of cases
ABSTRACT
Henoch Schonlein Purpura is the most frequent vasculitis in children. Renal involvement is variable. Renal manifestations vary from isolated microscopic hematuria to the association on nephrotic syndrome to nephritic syndrome. To determine the predictors of severe Henoch - Schönlein nephritis. Retrospective study over 15 years [1996-2010] of 34 chidren, with henoch-schonlein nephritis. Renal involvement was determined in 68.7%. Mean age was 7.23 years [3-14 years]. Renal manifestations were variable. Moderate renal manifestations were noted in 15 cases. Microscopic hematuria was observed in 23.5% of cases and moderate proteinuria with or without hematuria is noted in 20.5% of cases. Severe nephritis was noted in 18 cases: nephrotic syndrome in 29.5% and nephrotic syndrome associated to nephritic syndrome in 23.5%. Hypertension without urinary anomalies was observed in one case. In univariate analysis, factor predictive of severe nephritis were: male sex, macroscopic hematuria, biologic inflammatory syndrome and leukocytosis. In multivariate analysis, only the leukocytosis was predictor of severity. In our study, only leukocytosis was predictor of severity in henoch-schönlein nephritis