Volume : 13, Issue : 08, August – 2026
Title:
NEPHROTIC SYNDROME IN SAUDI CHILDREN: A SYSTEMATIC REVIEW OF CLINICAL CHARACTERISTICS, MANAGEMENT AND OUTCOMES
Authors :
Dr. Mohammed Alqasimi, Dr. Aliya Alothman, Dr. Mohammad Abdullah Almazeedi
Abstract :
Background: Paediatric Nephrotic Syndrome (NS) is a major chronic disorder characterized by heavy proteinuria, hypoalbuminemia, hyperlipidaemia, and peripheral edema. While minimal change disease (MCD) is the predominant histopathology globally, paediatric populations in Saudi Arabia demonstrate distinct generic patterns, higher rates of consanguinity, and a varying prevalence of steroid-resistant nephrotic syndrome. (SRNS).
Methods: A systematic literature search was conducted across Medline/PubMed, EMBASE, and reginal databases following PRISMA guidelines. Observational cohort studies, retrospective reviews, and clinicopathological studies focusing on paediatric primary nephrotic syndrome in Saudi Arabia evaluated.
Results: Synthesis of included studies indicates a median age of presentation between 3 and 5.5 years, with a male-to-female ratio ranging from 1.5:1 to 2.3:1. Initial responsiveness to corticosteroid therapy ranges between 70% and 85%. However, among biopsy-proven steroid-resistant cases, Focal Segmental Glomerulosclerosis (FSGS) is the single most common histopathological pattern (39-54%), followed by IgM nephropathy, Mesangioproliferative Glomerulonephritis (MesPGN), and MCD variants. Familial clustering is noted in up to 6-12% of cases, strongly correlated with high rates of consanguinity. Calcineurin inhibitors (tacrolimus, cyclosporine) and mycophenolate mofetil remain the primary second-line immunosuppressive protocols are key to optimizing long-term renal outcomes.
Conclusion: Saudi children with nephrotic syndrome demonstrate a high burden of focal segmental glomerulosclerosis, elevated risk of steroid dependency or resistance, and significant risk of infectious complications (predominantly peritonitis and urinary tract infections). Early genetic screening for podocyte gene mutations and aggressive second -line immunosuppressive protocols are key to optimizing long-term renal outcomes.
Keywords: Paediatric Nephrotic Syndrome, Saudi Arabia, Minimal Change Disease, Focal segmental Glomerulosclerosis, Steroid-Resistant Nephrotic Syndrome, Immunosuppression.
Cite This Article:
Please cite this article in press Dr. Mohammed Alqasimi et al., Nephrotic Syndrome in Saudi children: A systematic review of clinical characteristics, management and outcomes.,, Indo Am. J. P. Sci, 2026; 13(08).
REFERENCES:
1. Al-Saran, K., et al. (1990). Nephrotic syndrome in Saudi children: clinicopathological study of 150 cases. PubMed / Regional Pediatric Nephrology Report, 2242321.
2. Kari, J. A., Halawani, M., Mokhtar, G., Jalalah, S. M., & Anshasi, W. (2009). Histopathology of steroid-resistant nephrotic syndrome in children living in the Kingdom of Saudi Arabia. Pediatric Nephrology, 24(7), 1429–1430.
3. Kari, J. A., et al. (2009). Pattern of steroid resistant nephrotic syndrome in children living in the kingdom of Saudi Arabia: a single center study. PubMed / Saudi Medical Literature, 19736491.
4. Alshahrani, A., et al. (2013). Patterns of Childhood Nephrotic Syndrome in Aljouf Region, Saudi Arabia. Saudi Journal of Kidney Diseases and
Transplantation, 24(5), 1045–1050.
5. Niaudet, P. (2004). Steroid-resistant idiopathic nephrotic syndrome in children. In Pediatric Nephrology (5th ed., pp. 545–573). Philadelphia: Lippincott Williams & Wilkins.
6. StatPearls Publishing. (2023). Pediatric Nephrotic Syndrome: Clinical Presentation, Evaluation, and Pathophysiology. NCBI Bookshelf, NBK470444.
7. Paediatric Nephrology Society. (2024). Clinical Practice Recommendations for Management of Steroid-Sensitive and Steroid-Resistant Nephrotic Syndrome in Children.
8. ResearchGate Clinical Reports. (2026). Clinical Profile and Complications of Primary Nephrotic Syndrome in Pediatric Patients.
9. King Hussein Medical Center Reports. (2022). Steroid Resistant Nephrotic Syndrome in Pediatric Patients: Histopathological Patterns and Outcomes in Regional Arab Cohorts.
10. KDIGO Kidney Disease: Improving Global Outcomes Glomerular Diseases Work Group. (2021). KDIGO Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney International, 100(4S), S1–S276.