Clinical Profile and Outcomes of Childhood Nephrotic Syndrome at Lagos Island General Hospital, South West Nigeria

Childhood nephrotic syndrome is one of the most common renal disorders requiring specialist paediatric management in sub-Saharan Africa. In Nigeria, clinical presentations often differ from patterns described in Western literature due to the high prevalence of secondary causes including malaria and hepatitis B. This retrospective study describes the clinical profile, management, and outcomes of childhood nephrotic syndrome at Lagos Island General Hospital, Lagos State, South West Nigeria, over a four-year period from 2020 to 2023. Medical records of 98 children aged one to 15 years with confirmed nephrotic syndrome were reviewed. Variables included age at diagnosis, clinical features, laboratory parameters, response to steroid therapy, relapse frequency, and outcome. Minimal change disease was the presumptive primary diagnosis in 54.1% of steroid-responsive cases. Secondary nephrotic syndrome associated with malaria or hepatitis B was identified in 22.4% of cases. Initial steroid responsiveness was observed in 68.4% of patients. Relapse occurred in 38.7% of responsive children during the study period. Complications recorded included infections (41.8%), hypertension (28.6%), and thrombosis (4.1%). Mortality rate was 7.1%. Delayed diagnosis beyond four weeks from symptom onset was associated with a significantly higher complication rate. The study recommends establishing standardised nephrotic syndrome management protocols, training paediatricians in renal disease recognition, and improving access to renal biopsy and specialist nephrology services. Keywords: nephrotic syndrome, children, steroid response, Lagos, South West Nigeria.