Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa

In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young a...
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Autor*in:	Udo Vester [verfasserIn] Augustin Fombah [verfasserIn] Maite Hölscher [verfasserIn] Danlami Garba [verfasserIn] Mary Tapgun [verfasserIn] Pamela Collier N‘Jai [verfasserIn] Philipp Mendy [verfasserIn] Gibril Bass [verfasserIn] Abdul K. Muhammad [verfasserIn] Suzanne T. Anderson [verfasserIn] Abdoulie Sanneh [verfasserIn] Charles Onyeama [verfasserIn] Udo Helmchen [verfasserIn] Khalifa Bojang [verfasserIn] Peter F. Hoyer [verfasserIn] Tumani Corrah [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa

Übergeordnetes Werk:	In: Frontiers in Pediatrics - Frontiers Media S.A., 2013, 10(2022)
Übergeordnetes Werk:	volume:10 ; year:2022

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fped.2022.854719

Katalog-ID:	DOAJ048973076

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520			\|a In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases.
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allfields	10.3389/fped.2022.854719 doi (DE-627)DOAJ048973076 (DE-599)DOAJ31bb26a7a18c47fcb4e740b9dc80ddac DE-627 ger DE-627 rakwb eng RJ1-570 Udo Vester verfasserin aut Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases. kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa Pediatrics Augustin Fombah verfasserin aut Maite Hölscher verfasserin aut Danlami Garba verfasserin aut Mary Tapgun verfasserin aut Pamela Collier N‘Jai verfasserin aut Philipp Mendy verfasserin aut Gibril Bass verfasserin aut Abdul K. Muhammad verfasserin aut Suzanne T. Anderson verfasserin aut Abdoulie Sanneh verfasserin aut Charles Onyeama verfasserin aut Udo Helmchen verfasserin aut Khalifa Bojang verfasserin aut Peter F. Hoyer verfasserin aut Tumani Corrah verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 10(2022) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:10 year:2022 https://doi.org/10.3389/fped.2022.854719 kostenfrei https://doaj.org/article/31bb26a7a18c47fcb4e740b9dc80ddac kostenfrei https://www.frontiersin.org/articles/10.3389/fped.2022.854719/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022
spelling	10.3389/fped.2022.854719 doi (DE-627)DOAJ048973076 (DE-599)DOAJ31bb26a7a18c47fcb4e740b9dc80ddac DE-627 ger DE-627 rakwb eng RJ1-570 Udo Vester verfasserin aut Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases. kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa Pediatrics Augustin Fombah verfasserin aut Maite Hölscher verfasserin aut Danlami Garba verfasserin aut Mary Tapgun verfasserin aut Pamela Collier N‘Jai verfasserin aut Philipp Mendy verfasserin aut Gibril Bass verfasserin aut Abdul K. Muhammad verfasserin aut Suzanne T. Anderson verfasserin aut Abdoulie Sanneh verfasserin aut Charles Onyeama verfasserin aut Udo Helmchen verfasserin aut Khalifa Bojang verfasserin aut Peter F. Hoyer verfasserin aut Tumani Corrah verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 10(2022) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:10 year:2022 https://doi.org/10.3389/fped.2022.854719 kostenfrei https://doaj.org/article/31bb26a7a18c47fcb4e740b9dc80ddac kostenfrei https://www.frontiersin.org/articles/10.3389/fped.2022.854719/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022
allfields_unstemmed	10.3389/fped.2022.854719 doi (DE-627)DOAJ048973076 (DE-599)DOAJ31bb26a7a18c47fcb4e740b9dc80ddac DE-627 ger DE-627 rakwb eng RJ1-570 Udo Vester verfasserin aut Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases. kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa Pediatrics Augustin Fombah verfasserin aut Maite Hölscher verfasserin aut Danlami Garba verfasserin aut Mary Tapgun verfasserin aut Pamela Collier N‘Jai verfasserin aut Philipp Mendy verfasserin aut Gibril Bass verfasserin aut Abdul K. Muhammad verfasserin aut Suzanne T. Anderson verfasserin aut Abdoulie Sanneh verfasserin aut Charles Onyeama verfasserin aut Udo Helmchen verfasserin aut Khalifa Bojang verfasserin aut Peter F. Hoyer verfasserin aut Tumani Corrah verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 10(2022) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:10 year:2022 https://doi.org/10.3389/fped.2022.854719 kostenfrei https://doaj.org/article/31bb26a7a18c47fcb4e740b9dc80ddac kostenfrei https://www.frontiersin.org/articles/10.3389/fped.2022.854719/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022
allfieldsGer	10.3389/fped.2022.854719 doi (DE-627)DOAJ048973076 (DE-599)DOAJ31bb26a7a18c47fcb4e740b9dc80ddac DE-627 ger DE-627 rakwb eng RJ1-570 Udo Vester verfasserin aut Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases. kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa Pediatrics Augustin Fombah verfasserin aut Maite Hölscher verfasserin aut Danlami Garba verfasserin aut Mary Tapgun verfasserin aut Pamela Collier N‘Jai verfasserin aut Philipp Mendy verfasserin aut Gibril Bass verfasserin aut Abdul K. Muhammad verfasserin aut Suzanne T. Anderson verfasserin aut Abdoulie Sanneh verfasserin aut Charles Onyeama verfasserin aut Udo Helmchen verfasserin aut Khalifa Bojang verfasserin aut Peter F. Hoyer verfasserin aut Tumani Corrah verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 10(2022) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:10 year:2022 https://doi.org/10.3389/fped.2022.854719 kostenfrei https://doaj.org/article/31bb26a7a18c47fcb4e740b9dc80ddac kostenfrei https://www.frontiersin.org/articles/10.3389/fped.2022.854719/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022
allfieldsSound	10.3389/fped.2022.854719 doi (DE-627)DOAJ048973076 (DE-599)DOAJ31bb26a7a18c47fcb4e740b9dc80ddac DE-627 ger DE-627 rakwb eng RJ1-570 Udo Vester verfasserin aut Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases. kidney proteinuria—nephrotic syndrome kidney biopsy histology West Africa Pediatrics Augustin Fombah verfasserin aut Maite Hölscher verfasserin aut Danlami Garba verfasserin aut Mary Tapgun verfasserin aut Pamela Collier N‘Jai verfasserin aut Philipp Mendy verfasserin aut Gibril Bass verfasserin aut Abdul K. Muhammad verfasserin aut Suzanne T. Anderson verfasserin aut Abdoulie Sanneh verfasserin aut Charles Onyeama verfasserin aut Udo Helmchen verfasserin aut Khalifa Bojang verfasserin aut Peter F. Hoyer verfasserin aut Tumani Corrah verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 10(2022) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:10 year:2022 https://doi.org/10.3389/fped.2022.854719 kostenfrei https://doaj.org/article/31bb26a7a18c47fcb4e740b9dc80ddac kostenfrei https://www.frontiersin.org/articles/10.3389/fped.2022.854719/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2022
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title_sort	etiology of kidney diseases with proteinuria in the gambia/west africa
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title_auth	Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa
abstract	In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases.
abstractGer	In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases.
abstract_unstemmed	In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases.
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title_short	Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa
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To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids.ResultsThe median age was 14.9 years (range 1.8–52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). 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Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa

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