A follow up study of adult nephrotic syndrome in Nigerians: Outcome and predictors of endstage renal failure

Abstract

Clinical data from 88 patients who presented with the nephrotic syndrome and biopsy-proven glomerular disease were analysed to determine the outcome after 8 years of follow up, and to find out the influence of glomerular histology, sex, age, plasma creatinine, creatinine clearance, hypertension, 24-hour urinary protein excretion and microscopic haematuria, on the clinical course and outcome. The results showed that at the end of follow up (8 years), 13 patients (14.8%) had died from renal failure while 24 patients (27.2%) were in chronic renal failure. Persistent renal disease was still present in 29 patients (33.0%). Of the whole group (88), mortality and endstage renal failure were highest amongst patients with focal segmental glomerulosclerosis and membranoproliferative glomerulonephritis. Male sex, hypertension, impaired plasma creatinine and creatinine clearance in patients from these two groups were associated with progression to chronic renal failure and death from uraemia. At final observation hypertension and microscopic haematuria were marked features of these two histological groups. Prognosis in minimal change nephropathy was quite good with remission occurring in 20 patients (66.6%); persistant renal disease however occurred in 8 patients (26.6%) while 1 patient died from uraemia