Clinicopathologic features and the association with short-term outcome of primary membranous nephropathy in children : a single-center study from Pakistan

Abstract EN

Membranous nephropathy (MN) is an uncommon cause of steroid-resistant nephrotic syndrome in children.

Our study aimed to determine the clinicopathologic features of primary MN in children and their association with short-term outcome.

This observational study was conducted from January 2009 to June 2017 at the Pediatric Nephrology Department.

A total of 50 children were diagnosed with primary MN.

Their clinical, laboratory, and histopathological findings on renal biopsy were recorded.

The minimum follow-up was for six months.

Clinico- pathologic features were correlated with the outcome at the last follow-up.

Data analysis was done using IBM SPSS Statistics for Windows software version 20.0.

The mean age at onset was 10.92 ± 3.08 years (range: 4–17 years).

The male-to-female ratio was 3:1.

The serum albumin of ≤2.5 g/dL was seen in 40 patients (80%), hypertension was present in 38 (76%), and heavy proteinuria was seen in 32 children (70%).

The mean estimated glomerular filtration rate (eGFR) at presentation was 178.71 ± 0.78 mL/min/1.73 m 2 .

At the initial visit, nine children (18.4%) were in chronic kidney disease stage 2 and one (2%) in stage 4.

Phospholipase A2 receptor antibody was present in five (15%) of 32 children tested.

At the last follow-up (28 interquartile range: 25.5 months), 11 children (26%) were in complete remission and 25 (66%) had achieved partial remission.

The mean eGFR had reduced to 145.84 ± 78.05 mL/min/1.73 m 2 .

Patients with normal initial eGFR were more likely to go into remission (P = 0.001).

The short-term outcome of childhood primary MN is relatively good in our setup.

A multicenter collaborative study is required to determine prognostic factors and to standardize treatment in this uncommon nephropathy.