Correlation between clinical symptoms and pathological features of the refractory nephrotic syndrome in 30 children

Objective To explore the correlation between clinical symptoms and pathological features of the refractory nephrotic syndrome in children.Methods The clinical symptoms and pathological features of 30 cases with refractory nephrotic syndrome in children were analyzed, as well as the therapeutic results. Results Clinically, most cases of the refractory nephritic syndrome in children were presented with proteinuria and hematuria, about 70 %. Pathologically, mesangioproliferative glomerulonephritis (MsPGN) was frequently seen, 43.3 %. Focal segmental glomerulosclerosis (FSGS) came second in incidence, 20 %. Membranoproliferative glomerulonephrits (MPGN) was about 13.3 % of the total cases, while IgA nephritis and minimal change glomerulonephritis (MCNS) were rarely found. Most cases in simple proteinuria group were pathologically mesangioproliferative glomerulonephritis, which proved to be steroid-dependent with frequent relapse ,but most cases in the proteinuria and hematuria group were focal segmental glomerulosclerosis and membranoproliferative glomerulonephrits in terms of pathology, which appeared steroid-resistant. Conclusions Most cases of children′s refractory nephritic syndrome were clinically proteinuria and hematuria. Its pathological changes could vary, however, mesangioproliferative glomerulonephritis was most common. The clinical symptoms and pathological features of the nephrotic syndrome and its reactions to steroid treatment seem closely related.