The Analysis Of Features And Risk Factors Of Pediatric Nephrotic Syndrome In Three Hospitals In Tanzania

Background:Nephrotic syndrome（NS）is a common kidney condition in children.It has been reported to result in increased morbidity,hospital stay,cost of treatment,different complications,and mortality among children.Various factors and pre-existing conditions have been associated and used to predict the risk of developing NS among children.However,the available evidence is mainly from other countries,and it’s inadequately studied in Tanzania,specifically Pemba Zanzibar.Therefore,this study was done to determine the clinical characteristic,proportion and related risk factors of hospitalized children with NS in two secondary hospitals and one tertiary hospital in TanzaniaObjective:To determine the proportion,clinical characteristics,and related risk factors of hospitalized children with NS in two secondary hospitals and one tertiary hospital in Tanzania.MethodologyA retrospective study was conducted in Pemba-Zanzibar,Tanzania,involving a review of the hospital database for children admitted in Pediatrics departments of two secondary hospitals and one tertiary hospital from January 01^stto June 30^th,2018.According to Tanzania’s Standard Treatment Guidelines and Essential Medicines List for Children and Adolescents,we diagnosed nephrotic syndrome.Below are the criteria:（1）Generalized body swelling worse in the morning,(2 Dipstick urine protein,3+or 24 hours urinary protein>40 mg/m²/h or a protein-to-creatinine ratio greater than 2.0（more than 200 mg/mmol）or>1000 mg/m²/day;（3）Hypoalbuminemia<25g/L or<2.5g/d L.And（4）Raised serum cholesterol and triglyceride levels.Then the proportion,co-existing diseases/factors,risk factors,and complications of the nephrotic syndrome were analyzed using SPSS version 25;Chi-square was used to determine statistical significance;P<0.05 and univariate binary logistic regression to identify the risk factors of NS in children.ResultsIn total,871 patients were included.Eleven patients met the diagnostic criteria of nephrotic syndrome（1.26%）.（73,8.38%）patients had diseases or other factors that may predispose them to nephrotic syndrome,including diabetes mellitus,sickle cell disease,HIV,malaria,hepatitis B,and renal diseases（glomerulonephritis）,family history of acute kidney injury（AKI）,history of NSAIDS use.The majority50,（5.74%）of 871 patients had sickle cell disease.Among the 11 patients with nephrotic syndrome,6（54.55%）had a history of using NSAIDs,5,（45.45%）had malaria,3（27.3%）had sickle cell disease,and 2（18.2%）had a family history AKI,1（9.1%）had glomerulonephritis,and 1（9.1%）had hepatitis B.The incidence of NS was significantly higher in patients with sickle cell disease（B=1.87,P=0.007）,malaria（B=5.47,P<0.01）,family history of acute kidney injury,and history of using NSAIDs(B=4.56,P<0.01（and B=5.87,P<0.01）consecutively.Furthermore,patients with nephrotic syndrome were found to develop complications of anemia 9,（81.81%）,infections（urinary tract infection and pneumonia）8,（72.72%）,hypertension6,（54.55%）and renal failure 2,（18.18%）.Conclusion:NS is uncommon in Pemba Zanzibar Tanzania.Sickle cell disease,malaria,family history of acute kidney injury,and history of using NSAIDs may be associated with NS,but hard to draw a firm conclusion since the proportion of NS in Pemba Zanzibar Tanzania is the low and limited sample size.There are 0 figures,7 tables and 92 references.