Volume 30, Issue 172, June 2026

Histopathological Characteristics of Pediatric Steroid-Resistant Nephrotic Syndrome in Sudan: A Single-Center Retrospective Study

Nahla Allam^1,2♦, Fatima Ali¹, Eltigani M.A. Ali¹, Yasir Mahgoup¹, Rasha Hussain¹, Nadia Aldawi³, Mohmmed A. Mohmmedahmed⁴, Bashir A. Yousef^5,6

¹Centre for Pediatric Kidney Disease, Department of Pediatric Nephrology, Soba University Hospital, Khartoum, Sudan
²Faculty of Medicine, Alneelain University, Khartoum, Sudan
³Department of Pathology, Soba University Hospital, Khartoum, Sudan
⁴Pediatric Cardiac Intensive Care Department, Sudan Heart Centre, Khartoum, Sudan
⁵Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
⁶Department of Clinical Pharmacy and Pharmacology, Ibn Sina College for Medical Studies, Jeddah, Saudi Arabia

^♦Corresponding author
Dr. Nahla Allam, Centre for Pediatric Kidney Disease, Department of Pediatric Nephrology, Soba University Hospital, Khartoum, Zip Code: 13314, Sudan.

ABSTRACT

Background: Steroid-resistant nephrotic syndrome (SRNS) in childhood is a significant therapeutic challenge and represents a high-risk factor for advancing towards end-stage renal disease (ESRD). Renal biopsy is necessary to define the exact histopathological type, which would direct subsequent therapy. Therefore, this study aimed to investigate histological patterns and correlations between these patterns and clinical presentations and therapeutic outcomes in Sudanese children with SRNS. Methods: This is a retrospective study of 62 children with SRNS seen at the Pediatric Nephrology Unit of Soba University Hospital, Sudan, from July 2017 to September 2021. All patients have undergone ultrasound-guided percutaneous renal biopsy. Demographic data, clinical presentation, histological findings, treatment modalities, and therapeutic outcome were collected. Results: There was a male preponderance (69.4%), with a mean age of 10.96 ± 4.82 years. Generalized edema and hypertension were the most common presentations (95.2% and 69.4%, respectively). Among the different histopathological types noted, there were FSGS (43.5%) and MCD (28.5%) of the cases. Around 8% of the studied sample had a positive family history. The most common treatments used were angiotensinconverting enzyme inhibitors (ACEIs) and calcineurin inhibitors in 89% and 79% of the patients, respectively. Around 82% of the patients had sustained remission, and 14.5% developed ESRD. Conclusion: Among the SRNS-studied cases, various histopathological features were observed, with FSGS being the most common. Although most children were well-responsive to calcineurin inhibitors, the chance of progressing to ESRD remains high, which highlights the need for prompt renal biopsy and the significance of genetic testing in these cases.

Keywords: Steroid-Resistant Nephrotic Syndrome, Focal Segmental Glomerulosclerosis, Pediatric Nephrology, Renal Biopsy, Calcineurin Inhibitors, Sudan.

Medical Science, 2026, 30, e101ms3870

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Published: 15 June 2026