title: The challenges of caring for children with nephrotic syndrome in a tertiary institution in the Democratic Republic of Congo.
abstract: OBJECTIVE
  The care of children with resistant nephrotic syndrome (NS) in the Democratic Republic of Congo is compromised by resource deficiencies that range from inadequate healthcare budgets, to scarce laboratory facilities and inconsistent drug supplies. The aim of this study was to describe the clinical profile and management of children with nephrotic syndrome in Kinshasa, the country's capital and its largest city.
  
  
  METHODS
  We retrospectively reviewed the medical records of 62 patients with a diagnosis of NS, who were seen in the Paediatric Nephrology Unit at the University Hospital of Kinshasa between January 1983 and January 2008.
  
  
  RESULTS
  Of the 62 children diagnosed with nephrotic syndrome, 33 were boys and 29 were girls, giving a male to female ratio of 1.14:1. Their median age at initial presentation was 7.5 years (range: 1.5-13 years) with a peak incidence at six to nine years of age (38.7%). No cases of plasmodium malariae were isolated in our series. Sixteen (25.8%) of the children had resistant corticoid nephrotic syndrome and six of the children (9.7%) died.
  
  
  CONCLUSIONS
  Age, the prevalence of steroid-resistant NS and the mortality rate in our series were higher than those reported in Asian and Western countries.
authors.affiliation: Division of Paediatric Haemato-oncology and Nephrology, Department of Paediatrics, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
authors.forename: Michel Ntetani
authors.initials: MN
authors.lastname: Aloni
authors.forename: Létycia Mizèle
authors.initials: LM
authors.lastname: Sysleyne
authors.forename: Pépé Mfutu
authors.initials: PM
authors.lastname: Ekulu
authors.forename: Francis Lukebadio
authors.initials: FL
authors.lastname: Babio
authors.forename: René Makuala
authors.initials: RM
authors.lastname: Ngiyulu
authors.forename: Jean Lambert
authors.initials: JL
authors.lastname: Gini-Ehungu
mesh_terms: D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D003906:Developing Countries / Q000706:statistics & numerical data*; D004351:Drug Resistance; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
keywords: Children; Democratic Republic of Congo; Kinshasa; Nephrotic syndrome