Short-term outcome of clinical and histopathologic variants of mesangiocapillary glomerulonephritis in children: A retrospective analysis from a tertiary care center.

OBJECTIVE: To study the frequency, clinicopathological features and short-term outcome of mesangiocapillary glomerulonephritis (MCGN) in children at a tertiary care kidney center in Pakistan. METHODS: A descriptive, observational study was conducted at the Paediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi, from January 2011 till December 2015. A review of all paediatric (<18 years) renal biopsies during the study period was performed and cases of MCGN were enrolled. The clinical presentation, laboratory findings, histology and outcome were analyzed. RESULTS: During the study period, 890 paediatric renal biopsies were performed. Of these, 63(7%) were MCGN. Among these, 34(54%) were males and 29 (46%) females. Mean age was 9.9 ± 3.2years. Thirty four (54%) presented with nephrotic syndrome (NS), and29 (46%) with rapidly progressive glomerulonephritis (RPGN).Mean duration of follow-up was 1.66 ± 1.34 years. Outcome of patients with NS with renal failure (RF)was complete remission (CR) in 1(7.7%), persistent proteinuria with normal renal functions in 1(7.7%),chronic kidney disease (CKD) in 3 (23%), end-stage renal disease (ESRD) in 4 (30.8%), while 4 (30.8%) children died, while in children with NS and normal renal functions, CR was obtained in 3(14.2%), partial remission (PR) in 10(47.6%),CKD in 4(19%), and ESRD in 3 (14.3%).Outcome of cases presenting as RPGN was CR in 13 (44.8%), CKD in 2(6.9%) and ESRD in 7(24.1%) cases. Four children (13.8%) were lost to follow-up, while 3(10.3%) died. CONCLUSIONS: Children with MCGN presenting clinically with NS with impaired renal functions have worst outcome.