The major shift from the communicable diseases to the non-communicable diseases in the 21st century has increased the incidence of syndromes like nephrotic syndrome to a great extent and is arising alarmingly to a very high rate. It may occur in its typical form or it may happen in combination with nephritic syndrome. Post streptococcal glomerulonephritis is commonly the care for the nephrotic and nephritic syndrome combination seen in children.
Earlier the nephrotic syndrome was a rare disease to be found and had very few numbers of cases per year but after the emergence of new world diseases in the past few decades or so, the nephrotic syndrome has seen a tremendous growth in its number of cases in past few years. According to a study there are about 20 cases per million population of the nephrotic syndrome in children whereas there are about 50 cases per million population of the nephrotic syndrome in adults. In Asia and South East Asian countries, the incidence of nephrotic syndrome stands at 1.99/lac population in children and 6.61/lac population in adults.
How Common Is Nephrotic Syndrome Or Is It Is A Rare Disease?
Nephrotic syndrome has diabetes mellitus as the most common cause in systemic illnesses, as the incidence of diabetes is rising exponentially in 21st century, the nephrotic syndrome has also become a common entity in in developing and the developed countries. Also, the autoimmune conditions and the inflammatory diseases has seen increase in its incidence over the past few years or a decade, the nephrotic syndrome has seen a growth in its incidence because it has the IGA nephropathy (peripheral form of Henoch Schonlein purpura) as most common cause in the children below 18 years of age. Other causes of nephrotic syndrome like HIV, amyloidosis has also increased in incidence over few years.
Incidence of chronic kidney disease has seen an outburst in the recent times which causes a lot of diseases via its complications and nephrotic syndrome happens to be one of them which in turn gets elevated in its incidence. As India is known to be TB capital of the world, tuberculosis has a high number of cases in India and it can also cause various kidney disorders one of which is nephrotic syndrome.
Variation of nephrotic syndrome has been noted according to the certain race and age-related demography. As the diabetes mellitus is found to be more common in African and Asian countries, it has high incidence among Asian African, Indians and Hispanics which is commoner than whites. Also, the risk of nephrotic syndrome due to HIV has increased in the educationally backward areas due to lack of the awareness about the spread of HIV and its complications via unprotected sex and other routes of transmission. Male and female preponderance of the disease nearly equal but slight male preponderance in seen in systemic causes like diabetes. Male and female incidence is equal in children.
Few rare causes of nephrotic syndrome have also been discovered like Fabry disease and not much is known about the incidence of such causes.
Nephrotic syndrome is characterized by the loss of podocytes in the Bowman’s capsule resulting in leakage of protein and other components of the blood. When it combines with nephritic syndrome, it also become permeable to red blood cells resulting in hematuria. The combination is generally seen in post streptococcal glomerulonephritis.(1)
Although the number of cases is not very high among lacs of population but it remains to be a condition which needs urgent attention to its causes. The number of case reduction can be improved only by decreasing the non-communicable diseases and the epidemic of such diseases like diabetes. Case reduction of tuberculosis is very much necessary as genitourinary tuberculosis remains at 3rd place in all cases causing nephrotic syndrome. So, all in all nephrotic syndrome is not a disease with rare etiology.
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