Biopsy findings in a selected pediatric population in Algeria : a retrospective study of 82 cases

Pediatric glomerular disease patterns vary by region, yet biopsy data from North Africa remain scarce. This study aimed to describe the clinicopathological spectrum in Algerian children who underwent kidney biopsy at an adult nephrology unit, and to identify diagnostic predictors within this selected cohort. We conducted a single-center retrospective study (2019–2025) including all native kidney biopsies from patients aged < 18 years. Clinical, laboratory, and histopathological data were analyzed using logistic regression, descriptive ROC analysis, and Spearman correlation. Missing data were handled by complete-case analysis. Biopsies were performed only when steroid resistance or atypical presentation was suspected – a strong referral bias that precludes any claim of population-based prevalence. A total of 82 children (55 boys, 67.1% ; mean age 12.9 ± 4.1 years) were included. Minimal change disease (MCD) was the most frequent diagnosis (30/82, 36.6%), followed by focal segmental glomerulosclerosis (FSGS, 20/82, 24.4%) and lupus nephritis (14/82, 17.1%). On multivariable analysis, age independently predicted FSGS versus MCD (adjusted odds ratio 1.38 per year ; 95% confidence interval 1.05–1.81 ; P = 0.02). In the lupus nephritis subgroup ( n = 14), proteinuria > 5 g/24 h was associated with an activity index ≥ 6 (OR = 8.5, 95% CI 1.2–60.1, P = 0.03), although this finding requires validation in larger cohorts. The activity index correlated with serum creatinine (Spearman’s ρ = 0.52, P = 0.046). In this selected cohort of Algerian children referred to an adult nephrology center, MCD, FSGS, and lupus nephritis were the predominant biopsy findings. Age independently predicted FSGS, and heavy proteinuria was associated with active lupus histology. However, these results are not generalizable to the general pediatric population because of significant referral bias, particularly the underrepresentation of steroid-sensitive nephrotic syndrome. This study provides essential descriptive baseline data for pediatric nephrology in North Africa and highlights the urgent need for population-based registries.