Evidence-based treatment limitations prevent any therapeutic recommendation for acute poststreptococcal glomerulonephritis in children (original) (raw)
Related papers
Overview on Acute Poststreptococcal Glomerulonephritis in Pediatrics: A Review
Journal of Pharmaceutical Research International, 2021
Acute poststreptococcal glomerulonephritis (APSGN) is the most common kind of post-infectious glomerulonephritis and is caused by group A streptococcus (Streptococcus pyogenes). Although the prevalence of PSGN has decreased in affluent nations, non-streptococcal species are becoming more common. and it is still the major cause of glomerulonephritis in children. APSGN can manifest itself in epidemic outbreaks or clusters of instances, as well as in single persons. Epidemic outbreaks have previously been documented as a result of upper respiratory or cutaneous streptococcal infections in various parts of the world. In developed nations, APSGN is now mostly a disease of the elderly, who are more likely to have disabling illnesses such as cancer, alcoholism, or diabetes. Children between the ages of 3 and 12 (with a peak incidence between the ages of 5 and 6 years) and seniors over the age of 60 are the most commonly affected. The pathophysiology of APSGN is complicated by inflammation....
Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children
Pediatric Nephrology, 2008
Post-streptococcal glomerulonephritis (PSGN) is the commonest cause of severe acute glomerulonephritis in New Zealand children, with the majority (85%) of the patients being of either Pacific Island or Maori ethnicity. We have performed a retrospective study on 27 pediatric patients with acute PSGN. Of these patients, those with crescentic glomerulonephritis (n=11) had a greater tendency (72.7%) for needing acute dialysis and were left with persistent urinary sediment abnormalities after a mean follow-up of 3.2 years (95% confidence interval 2.1-4.3). The efficacy of immunosuppression in the group with crescentic disease was uncertain. The severity of renal histopathological abnormalities as judged by the total biopsy score did not correlate with either presentation or eventual outcome. Severe childhood acute post-streptococcal glomerulonephritis, although uncommon, results in significant long-term renal morbidity, particularly among Maori and Pacific Island children.
Prognostic factors for mortality in pediatric acute poststreptococcal glomerulonephritis
Paediatrica Indonesiana, 2016
Background Acute post-streptococcal glomerulonephritis (APSGN) is one of the most common causes of glomerular disease in developing countries, including Indonesia. It can lead to end stage renal failure and higher mortality rates. To decrease morbidity and mortality, it is important to understand the prognostic factors affecting the disease.Objective To identify prognostic factors affecting outcomes in pediatric APSGN patients.Methods Study data were collected from medical records of patients with APSGN hospitalized in Wahidin Sudirohusodo Hospital, Makassar in 2009-2013. Possible prognotic factors analyzed were gender, age, nutritional status, level of consciousness, as well as proteinuria, hemoglobin, serum albumin, urea, and creatinine levels.Results Of 86 subjects, 82 (95.3%) survived and 4 (4.7%) died. Fifty-three (61.6%) patients were male and 33 (38.4%) were female. Subjects’ ages ranged from 3.42 to 14.67 years, with a mean age of 9.36 years. Multivariate analysis revealed s...
Acute Kidney Injury and Atypical Features during Pediatric Poststreptococcal Glomerulonephritis
International Journal of Nephrology, 2016
The most common acute glomerulonephritis in children is poststreptococcal glomerulonephritis (PSGN) usually occurring between 3 and 12 years old. Hypertension and gross hematuria are common presenting symptoms. Most PSGN patients do not experience complications, but rapidly progressive glomerulonephritis and hypertensive encephalopathy have been reported. This paper reports 17 patients seen in 1 year for PSGN including 4 with atypical PSGN, at a pediatric tertiary care center. Seventeen children (11 males), mean age of 8 years, were analyzed. Ninety-four percent had elevated serum BUN levels and decreased GFR. Four of the hospitalized patients had complex presentations that included AKI along with positive ANA or ANCAs. Three patients required renal replacement therapy and two were thrombocytopenic. PSGN usually does not occur as a severe nephritis. Over the 12-month study period, 17 cases associated with low serum albumin in 53%, acute kidney injury in 94%, and thrombocytopenia in ...
The Israel Medical Association journal : IMAJ, 2016
BACKGROUND The incidence of post-infectious glomerulonephritis (PIGN) has decreased over the last decades. As a result, recent epidemiological data from industrialized countries are scarce. OBJECTIVES To evaluate patterns of PIGN in children and detect possible predictors of disease severity. METHODS We collected clinical and laboratory data of patients with PIGN admitted to Schneider Children's Medical Center during 1994-2011. Diagnostic criteria included presence of hematuria with/without other features of nephritic syndrome along with hypocomplementemia and/or microbiological/serological evidence of streptococcal infection. Patients with other diseases (systemic lupus erythematosus, vasculitis, etc.) were excluded from the study. RESULTS A total of 125 patients with a mean age of 5.8 ± 3.3 years (range 1.5-17.6), of whom 16% were < 3 years, matched the study criteria. Presenting features included hypertension in 103 (82.4%) patients, azotemia in 87 (70.2%), fever in 49 (40...
Infectious Disease Reports, 2022
Postinfectious glomerulonephritis (PIGN) is an immune-mediated acute glomerulonephritis classically seen weeks after infection with Streptococcus pyogenes, although other infectious etiologies have emerged. While it has become increasingly rare in industrialized regions, it continues to affect children in developing countries. There has been debate as to why incidence rates are declining, including the possibility of improved initial treatment of bacterial infections. The ability of antimicrobial therapy in preventing PIGN as infectious sequelae, however, has not been comprehensively assessed. As varying evidence from published studies exists, the objective of this meta-analysis is to determine if antimicrobial therapy utilized to treat an initial infection has an effect in reducing the development of PIGN in humans. EMBASE, MEDLINE, and CENTRAL were searched using a comprehensive terminology strategy. From an initial search that returned 337 publications, 9 articles were included f...
International Journal of Research in Medical Sciences
Background: Acute glomerulonephritis (AGN), the commonest of which is acute post streptococcal glomerulonephritis, is common in school aged children and typically presents with haematuria, oedema, oliguria and varying degrees of renal insufficiency. This study evaluated epidemiologic factors, presentations and treatment outcome of AGN patients at University of Uyo Teaching Hospital, (UUTH), Uyo, Nigeria.Methods: This cross-sectional study was conducted among children with AGN at the paediatric nephrology unit of UUTH from January 2015 to December 2019. Data were analysed with statistical package for social sciences version 25 and p values <0.05 were considered statistical significant.Results: Fifteen out of 12,403 paediatric admissions had AGN, giving an average yearly hospital incidence of 3/year and 0.12% of total admission. Age range was three to 15 years. Mean age was 8.07±3.94 years and median was 7.00 years. Males were nine with a male/female ratio of 1.5:1. Eight (53.3%) b...
Clinical Presentations and Outcome of Acute Glomerulonephritis in Children
Bangladesh Medical Journal, 2019
Acute post streptococcal glomerulonephritis (APSGN) is the most common type of acute glomerulonephritis (AGN) in childhood. It has not been studied well in Bangladesh. To evaluate the clinical characteristics, complications and outcome of Acute post streptococcal glomerulonephritis (AGN). the
Acute Post-Streptococcal Glomerulonephritis in Children A Review
Bangladesh Journal of Child Health, 2014
Acute poststreptococcal glomerulonephritis (APSGN) is characterized by abrupt onset of hematuria, edema, hypertension, oliguria and impaired renal function following streptococcal group A â hemolytic streptococcal throat and skin infection. There is a declining incidence of APSGN worldwide, particularly in industrialized nations because of easier and earlier access to competent medical treatment of streptococcal infections and the widespread use of fluorination of water since virulence factors in streptococcus pyogens are reduced with fluoride exposure. But in the underdeveloped world, global burden of APSGN continues to be significant with lower estimate of 9.3 to 9.8 cases per 1,00,000 population per year to higher estimates as high as three times these values. Furthermore, clusters of cases are more frequently reported in poor communities in industrialized countries while epidemics of more than 100 cases are reported in the middle ranger countries with mean annual health expenditure per capita of about 550 US dollars. APSGN typically follows 1to2 weeks after pharyngeal infection and 2 to 4 weeks after skin infection by nephritogenic strains of group A â hemolytic streptococcus in a range of 5-15 years of age. Subclinical cases are 4-10 times higher than symptomatic patients. The acute phase generally resolves within 4-8 weeks but microscopic hematuria may persist for 1-2 yr after the initial presentation. Acute complications of symptomatic patients are hypertensive heart failure, encephalopathy and retinopathy. There can be acute renal failure and rarely rapidly progressive (crescentic) glomerulonephritis, hyperkalemia, hyperphosphatemia, hypocalcemia and acidosis.