• Syed Sajid Hussain Shah Department of Paediatric Nephrology, The Children’s Hospital and The Institute of Child Health, Lahore
  • Naureen Akhtar Department of Paediatric Nephrology, The Children’s Hospital and The Institute of Child Health, Lahore
  • Faiza Sunbleen Department of Paediatric Radiology, The Children’s Hospital and The Institute of Child Health, Lahore
  • Mohammad Fahim ur Rehman Department of Paediatric Nephrology, The Children’s Hospital and The Institute of Child Health, Lahore
  • Tausif Ahmed Department of Paediatrics Abbottabad, International Medical College, Abbottabad


Background: Steroid-resistant nephrotic syndrome (SRNS) is a common problem but difficult to treat for pediatric nephrologists. Due to paucity of studies done in few centres in southern Pakistan regarding the histopathological aspects in paediatric patients with SRNS, this study was conducted to determine the histopathological spectrum in children with SRNS at our centre. Methods: This descriptive study has been conducted at the Nephrology department, The Children’s Hospital Lahore from February 2014 to January 2015. Based upon history, physical examination and laboratory results, all patients diagnosed as idiopathic SRNS were included in the study and renal biopsy was done to determine the underlying pathology. Histopathology reports were retrieved and data analysis done using SPSS-20.0. Results: There were a total of 96 patients, 64 (66.7%) males and 32 (33.3%) females. The age range was from 0.80 to 15 years with mean age of presentation being 6.34+3.75 years. The most common histo-pathological pattern was mesangio-proliferative Glomerulonephritis found in 79 (82.3%) cases followed by Focal segmental glomerulosclerosis (FSGS) in 9 (9.4%) patients while Minimal change disease (MCD) was seen in 5 (5.2%) subjects. Conclusion: Mesangioproliferative glomerulonephritis is the most common histological pattern seen in children presenting with idiopathic SRNS at our centre followed by FSGS and MCD


Pais P, Avner ED. Nephrotic Syndrome. In: Kliegmam RM, Stanton BF, Geme JWS, Schor NF, Behrman RE, editors. Nelson Textbook of Pediatrics. Philadelphia: Elsevier; 2011. p. 1801-7.

Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet 2003;362(9384):629–39.

Churg J, Habib R, White RH. Pathology of the nephrotic syndrome in children. A report for the International Study of Kidney Disease in Children. Lancet 1970;295(7660):1299–1302.

van Husen M, Kemper MJ. New therapies in steroid-sensitive and steroid-resistant idiopathic nephrotic syndrome. Pediatr Nephrol 2011;26(6):881–92.

Kari JA, Halawani M, Mokhtar G, Jalalah SM, Anshasi W. Pattern of steroid resistant nephrotic syndrome in children living in the kingdom of Saudi Arabia. Saudi J Kidney Dis Transpl 2009;20(5):854–57.

Gulati S, Sengupta D, Sharma RK, Sharma A, Gupta RK, Singh U et al. Steroid resistant nephrotic syndrome: Role of histopathology. Indian Pediatr 2006;43(1):55–60.

Troyanov S, Wall CA, Miller JA, Scholey JW, Cattran DC, Toronto Glomerulonephritis Registry Group: Focal and segmental glomerulosclerosis: definition and relevance of a partial remission. J Am Soc Nephrol 2005;16:1061–8.

Mekahli D, Liutkus A, Ranchin B, Yu A, Bessenay L, Girardin E, et al. Long-term outcome of idiopathic steroid-resistant nephrotic syndrome: a multicenter study. Pediatr Nephrol 2009;24(8):1525–32.

Waldo FB, Benfield MR, Kohaut EC. Therapy of focal and segmental glomerulosclerosis with methylprednisolone, cyclosporine A and prednisone. Pediatr Nephrol 1998;12(5):397–400.

Aviles DH, Irwin KC, Dublin LS, Vehaskari VM. Aggressive treatment of severe idiopathic focal segmental glomerulosclerosis. Pediatr Nephrol 1999;13(4):298–300.

Franke D, Zimmering M, Wolfish N, Ehrich JH, Filler G. Treatment of FSGS with plasma exchange and immunadsorption. Pediatr Nephrol 2000;14(10-11):965–9.

Barletta GM, Smoyer WE, Bunchman TE, Flynn JT, Kershaw DB. Use of mycophenolate mofetil in steroid-dependent and resistant nephrotic syndrome. Pediatr Nephrol 2003;18(8):833–7.

Magnasco A, Ravani P, Edefonti A, Murer L, Ghio L, Belingheri M, et al. Rituximab in Children with Resistant Idiopathic Nephrotic Syndrome. J Am Soc Nephrol 2012;23(6):1117–24.

Pradhan SK, Mutalik PP, Mohanty AK. Pattern of steroid-resistant nephrotic syndrome in children and the role of histopathology: A single-centre study. South Afr J Child Health 2013;7(4):153–4.

Bagga A, Mantan M. Nephrotic syndrome in children. Indian J Med Res 2005;122(1):13–8.

Ehrich JH, Geerlings C, Zivicnjak M, Franke D, Geerlings H, Gellermann J. Steroid resistant idiopathic childhood nephrosis: Overdiagnosed and undertreated. Nephrol Dial Transplant 2007;22(8):2183–93.

Kari JA, Halawani M. Treatment of steroid resistant nephrotic syndrome in children. Saudi J Kidney Dis Transpl 2010;21(3):484–7.

Banaszak B, Banaszak P. The increasing incidence of initial steroid resistance in childhood nephrotic syndrome. Pediatr Nephrol 2012;27(6):927–32.

Mubarak M, Kazi JI, Shakeel S, Lanewala A, Hashmi S. The Spectrum of Histopathological Lesions in Children Presenting with Steroid-Resistant Nephrotic Syndrome at a Single Center in Pakistan. ScientificWorldJournal 2012; 2012:681802.

Azhar A, Ikram M, Amer S. Histological pattern of steroid resistant nephrotic syndrome in children: a single centre study. J Med Sci 2011;19(2):98–101.

Moorani KN, Sherali AR. Histopathological pattern in childhood Glomerulonephritis. J Pak Med Assoc 2010;60(12):1006–9.

Ali A, Ali MU, Akhtar SZ. Histological pattern of paediatric renal diseases in Northern Pakistan. J Pak Med Assoc 2011;61(7):653-8.

Lanewala A, Mubarak M, Akhter F, Aziz S, Bhatti S, Kazi JI. Pattern of pediatric renal disease observed in native renal biopsies in Pakistan. J Nephrol 2009;22(6):739–46.

Seif EI, Ibrahim EAS, Elhefnawy NG, Salman MI. Histological patterns of idiopathic steroid resistant nephrotic syndrome in Egyptian children: A single centre study. J Nephropathol 2013;2(1):53–60.



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