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- Title
National survey found that managing childhood nephrotic syndrome in Nigeria varied widely and did not comply with the best evidence.
- Authors
Esezobor, Christopher I.; Asinobi, Adanze O.; Okafor, Henrietta U.; Akuse, Rosamund; Gbadegesin, Rasheed
- Abstract
<bold>Aim: </bold>This study explored any variations in managing childhood nephrotic syndrome between specialist centres in Nigeria and how closely the care reflected the best available evidence.<bold>Methods: </bold>In 2016, the heads of Nigerian paediatric nephrology units were asked to complete a study questionnaire that focused on managing nephrotic syndrome.<bold>Results: </bold>Of the 31 clinicians we approached, 81% returned the completed questionnaire. The majority (64%) had received paediatric nephrology training and 40% had practised for at least 10 years. We found that 60% prescribed an initial daily prednisolone for four weeks before reducing the dose and 32% prescribed it for six weeks. However, more marked variations were observed with the total steroid duration for new-onset nephrotic syndrome, with 16%, 44% and 40% prescribing prednisolone for 8, 12 and at least 16 weeks, respectively. Similarly, 56% prescribed prednisolone for less than eight weeks before diagnosing steroid-resistant nephrotic syndrome (SRNS) and 12% rarely requested a kidney biopsy for SRNS. In addition, 32% of the respondents preferred cyclophosphamide to calcineurin inhibitors for SRNS.<bold>Conclusion: </bold>There were significant variations in the management of childhood nephrotic syndrome in Nigeria and the diagnosis and treatment of SRNS differed substantially from the best available evidence.
- Subjects
NIGERIA; NEPHROTIC syndrome treatment; NEPHROTIC syndrome in children; PEDIATRIC nephrology; PREDNISOLONE
- Publication
Acta Paediatrica, 2018, Vol 107, Issue 12, p2193
- ISSN
0803-5253
- Publication type
journal article
- DOI
10.1111/apa.14409