Persistent proteinuria in pediatric patients, histopathological characterization and its influence on chronic kidney disease progression

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Published: 2018-06-15
DOI: https://doi.org/10.18566/medupb.v37n1.a02

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Castillo Orozco, J., Gómez Restrepo, A., Puche Gómez, S., Mejía Mora, A., Sánchez Zapata, D. T., Nieto Ríos, J. F., & Higuita, L. S. (2018). Persistent proteinuria in pediatric patients, histopathological characterization and its influence on chronic kidney disease progression. Medicina UPB, 37(1), 9-16. https://doi.org/10.18566/medupb.v37n1.a02
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Juliana Castillo Orozco
Resident of Pediatrics, Faculty of Medicine, Universidad Pontificia Bolivariana. Medellin Colombia.
Andrea Gómez Restrepo
Resident of Pediatrics, Faculty of Medicine, Universidad Pontificia Bolivariana. Medellin Colombia.
Sara Puche Gómez
Medical student, Faculty of Medicine, Universidad Pontificia Bolivariana. Medellin Colombia.
Alejandra Mejía Mora
Medical student, Faculty of Medicine, Universidad Pontificia Bolivariana. Medellin Colombia.
Deisy Tatiana Sánchez Zapata
Medical student, Faculty of Medicine, Universidad Pontificia Bolivariana. Medellin Colombia.
John Fredy Nieto Ríos
Internist and Nephrologist, Pablo Tobón Uribe Hospital, Universidad de Antioquia. Medellin Colombia.
Lina Serna Higuita
Pediatric Nephrologist and Epidemiologist, Eberhard Karls University, Institute of Epidemiology and Biometrics. Tübingen, Germany.

Abstract

Objective: To describe the histopathological findings and their progression of chronic kidney disease in pediatric patients who underwent kidney biopsy due to persistent proteinuria during 2005-2015 at a high-complexity hospital in Medellin, Colombia.


Methods: A retrospective, cohort study was carried out; the medical records of children under 18 with diagnosis of persistent proteinuria were reviewed. Sociodemographic, clinical, and histopathological variables were analyzed.


Results: A total of 71 patients were included. The mean age at the diagnosis of persistent proteinuria was 10.07 years old. 69.1% and 20.6% of the patients had hematuria and hypertension, respectively. Overall, the predominant pathological diagnosis in the current study was IgA nephropathy (21.13%) followed by lupus nephropathy (18.31%). 69.0% of the patients received angiotensin-converting enzyme inhibitors. At the last follow-up, 15.9% presented impaired renal function.


Conclusion: In our cohort, the prevalence of glomerulopathies in children with persistent proteinuria was high. We recommended performing kidney biopsy in children with persistent proteinuria. This allows early detection of primary or secondary glomerulopathies to retard progression of renal damage.

Keywords:
proteinuria, child; biopsy, renal insufficiency, chronic

Article Details

References

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