Facilitating Earlier Discharge for Patients Undergoing Spine Surgery.

OBJECTIVE

To study the frequency, clinicopathological features and short-term outcome of mesangiocapillary glomerulonephritis (MCGN) in children at a tertiary care kidney center in Pakistan.

METHODS

A descriptive, observational study was conducted at the Paediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi, from January 2011 till December 2015. A review of all paediatric (<18 years) renal biopsies during the study period was performed and cases of MCGN were enrolled. The clinical presentation, laboratory findings, histology and outcome were analyzed.

RESULTS

During the study period, 890 paediatric renal biopsies were performed. Of these, 63(7%) were MCGN. Among these, 34(54%) were males and 29 (46%) females. Mean age was 9.9 ± 3.2years. Thirty four (54%) presented with nephrotic syndrome (NS), and29 (46%) with rapidly progressive glomerulonephritis (RPGN).Mean duration of follow-up was 1.66 ± 1.34 years. Outcome of patients with NS with renal failure (RF)was complete remission (CR) in 1(7.7%), persistent proteinuria with normal renal functions in 1(7.7%),chronic kidney disease (CKD) in 3 (23%), end-stage renal disease (ESRD) in 4 (30.8%), while 4 (30.8%) children died, while in children with NS and normal renal functions, CR was obtained in 3(14.2%), partial remission (PR) in 10(47.6%),CKD in 4(19%), and ESRD in 3 (14.3%).Outcome of cases presenting as RPGN was CR in 13 (44.8%), CKD in 2(6.9%) and ESRD in 7(24.1%) cases. Four children (13.8%) were lost to follow-up, while 3(10.3%) died.

CONCLUSIONS

Children with MCGN presenting clinically with NS with impaired renal functions have worst outcome.