Complication Profiles of Nephrotic Syndrome in Senegal: A Retrospective Study over 10 Years

Introduction: Complications of nephrotic syndrome (NS) are in many cases serious, as they affect thepatient’s prognosis. This study was conducted to assessing the prevalence of SNcomplications andidentifycomplications of nephrotic syndrome and its treatment.

Patients and methods: This was a retrospective descriptive study conducted in the nephrology department ofAristide Le Dantec Hospital in Dakar over 10 years from 1 January 2009 to 31 December 2018. All patientswith nephrotic syndrome who had at least one complication of NS were included. Epidemiological, clinical,paraclinical, therapeutic and evolutionary parameters were studied.

Results: Out of six hundred and four (604) patients with NS, four hundred and twenty-nine (429) had atleast one complication of NS, i.e., a hospital prevalence of 71.02%. The mean age was 40.54±12 years witha sex ratio (M/F) of 1.6. Segmental and focal hyalinosis was the main primary lesion found in 146 patients(50.8%). One hundred and forty-two patients (33.1%) had a secondary cause, including 99 (69.8%) withdiabetic nephropathy. Infectious complications were present in 160 patients (37.3%), and thromboemboliccomplications in 33 patients (7.71%). Ninety patients (36.3%) had hyponatremia. One hundred and sixtyseven patients (39%) had acute renal failure. Hypercholesterolemia was present in 54 patients (12.6%).Hypertriglyceridemia was noted in 35 patients (8.1%). One case of haemorrhagic cystitis was noted in 14patients treated with cyclophosphamide. Three cases of anaemia and one case of leukopenia were noted in the4 patients treated with mycophenolate mofetil. Among the 264 patients taking diuretics, hyperuricemia waspresent in 22.4% and hyponatremia in 21.5%. Seven cases of haemorrhagic syndrome were recorded in the 34patients treated with anticoagulants. No complications related to blockers of the renin-angiotensin-aldosteronesystem were noted.

Conclusion: From this study, we can say that complications of NS are frequent in our context and are dominatedby infectious and thrombo-embolic causes. These complications can be life-threatening, hence the importanceof early detection and appropriate management.

Keywords: Nephrotic Syndrome, Complications, Venous thrombosis, Infections, Hyperlipidemia.