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    Pathology,Epidemiology & Pathophysio:NephroticSyndrome


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    Pathology,Epidemiology & Pathophysio:NephroticSyndrome Empty Pathology,Epidemiology & Pathophysio:NephroticSyndrome

    Post  alkhaloidz on Fri 19 Jun 2009, 11:27 pm

    Dyad 4
    Zaņo, Alexis
    Balajadia, Bond

    Nephrotic Syndrome

    Primary or idiopathic Nephrotic syndrome is a collective term that describe the clinical picture of nephritic syndrome occurring in the absence of systemic disease, with an annual incidence of approximately 1-2 new cases per 100.000 population under the age of 16 years, The research entitled : Primary Nephrotic Syndrome – Mesangial Proliferative Glomerulonephritis In Childre: Clinicopathology and Treatment Outcome. This was a restrospective cohort study. A total of 117 patients with idiopathic syndrome biopsy proven masangial proloferative glumerulonephritis were seen at the Department of Pediatric Nephrology. National Kidney and Transplant Institute from January 1998 to December 2002. This was conducted to analize the clinic pathologic features and treatment outcome of the children with primary nephrotic syndrome biopsy confirmed mesagial proliferative glumerulonephritis. A retrospective analysis was carried out on all patients fulfilling the International Study of Kidney Disease in Children (ISKDC) criteria with onset between 1 and 16 years of age. Medical charts of patients were reviewed. Data gathered were clinical features, biochemical parameters, light and immunofluorescence microscopy co-morbities and treatment outcome (remmision, frequent relapse and no remission).

    The study subjects were predominantly males with mean age of onset 5.4 years. Less than 10% of the children had hypertension. Hematuria was observed in more than half of the population. The results of the baseline biochemical tests of all the patients showed hypoproteinemia (mean+0.9 gm/dl SD 0.5) and hypercholesterolemia (mean = 518 ng/dl SD= 134). All the serum creatinine were normal with the mean of 0.6 mg/dl (SD=17). Presence of anti-human IgG, IgM and fibrinogen were often seen among the frequent relapsers with the positive rates of 65.96%, 54.24% and 65.31% respectively. However, there is no sufficient evidence to show that the presence of these immunofluorescence findings was more common among the said group (p-value=0.157, p=0.3135 and 0.157 respectively). Upper repiratory tract infection was the most common co-morbidity with an average occurrence of 6 (SD=2.93).

    The study has provided a great deal of knowledge and significance on nursing care of patients with primary nephritic syndrome. The study reiterated the different treatment response and outcome that widens the prospect of treating the disease and adds on the development of nursing care plan for nephrotic syndrome. The histopathologic finding has been carefully studied to establish the features of nephrotic syndrome. As a result, much caution should be considered and implemented such as protecting the patient, prevent and limit exposure to subject of respiratory tract infection as the frequent relapse was the most prevalent outcome. On the other hand, its good thing to know though, that despite the severity and complexity of the disease, there are still children who has complete remissions with their treatment of the disease and able to live a normal life.

    Reference: Valderrama et al. Primary Nephrotic Syndrome-Mesangial. NKTI Proceedings 6. July 2004

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