Idiopathic Nephrotic Syndrome (INS) in Adults in Abidjan: Clinical and Therapeutic Aspects of 28 Cases

Abstract

Context + objective: Nephrotic syndrome accounts for 15 to 30% of glomerulopathies in adults; its evolution is difficult to predict. The objective of this work is to study the profile of patients suffering from idiopathic nephrotic syndrome in a nephrological hospital environment at the University Hospital of Yopougon in Abidjan. Methods: We carried out a retrospective study with descriptive and analytical purposes including any patient aged 15 and over who had had a clean kidney biopsy between January 2018 and October 2019 concluding in a nephrotic syndrome with minimal glomerular lesions (MGL) or segmental and focal hyalinosis (SFH) at the Nephrology Department of the University Hospital of Yopougon in Abidjan. Results: A total of 28 patients were collected. Patients with SFH type lesions were older with a statistically significant p value (p = 0.002). The male gender predominated in MGL type lesions without a statistically significant link (p = 0.26). SFH-type lesions were dominant (57.14%), followed by MGL-type lesions (42.86%). Oedematous syndrome was the main physical sign (n = 9; 56.25%) without significant difference (p = 0.742). ESRD with a GFR less than 15 mL/min/1.73 m2 was found in 8 patients, which is 28.6% without significant difference. Microscopic haematuria coexisted in 5 patients (17.9%) and hypertension in 7 patients (25%). The first-line treatment was oral corticosteroid therapy at usual doses (n = 28; 100%), associated with immunosuppressants (n = 11.79; 17%). Partial remission was noted in 9 MGL type patients, that is 69.2% and a total remission in SFH type patients that is 50%, without any statistically significant link (p = 0.568). The main complications were CRD in 9 patients, which is 45%, followed by dyslipidaemia that is 30%. Conclusion: Adult idiopathic nephrotic syndrome is common and dominated by SFH type of histological lesions. Its outcome is generally favourable.