Significant proteinuria: the Port-of-Spain General Hospital experience - abstract

ABSTRACT

Sixty-nine patients who had renal biopsies because of proteinuria of > 1 gm per day, oedema and normal sized kidneys were investigated. There were 58 adults and 11 children. Of the adults, 26 were male, and 32 female; of the 11 children, there were 10 males and 1 female. The modal age of the patients was 15 - 19 years. The majority of the patients (67 percent) had primary glomerular disease. The two most common histological patterns were minimal change and mesangio-capillary glomerulo-nephritis. Minimal-change nephritis was observed in 73 percent of children's kidney biopsies. The pattern was unlike that seen in tropical Africa. Mesangial-proliferative disease did not contribute remarkably (11 percent) to significant proteinuria. Membranous nephropathy, which usually accounts for the majority of idiopathic adult nephrotics in the developed countries, was rare in our Trinidadian series. Systemic lupus erythematous comprised the majority of patients (83 percent) who had secondary proteinuria. This may reflect a bias in the selection of patients for renal biopsy. Even though the incidence of the sickle-cell gene is high in Trinidad, sickle-cell disease did not contribute to the presence of nephropathy. The prognosis for patients with primary glomerular disease (21 percent mortality) was better than for thos with systemic disease (79 percent mortality). Our observations suggest that the pattern of proteinuria in Trinidad does not resemble that seen in tropical Africa but is some what similar to that observed in Jamaica (AU)