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Prognosis of acute poststreptococcal glomerulonephritis (APSGN) is excellent in children, when adequately diagnosed
T Kasahara1, H Hayakawa, S Okubo
1Department of Pediatrics, Niigata University School of Medicine, Niigata City, Japan. kasachan@med.niigata-u.ac.jp
Insights
The prognosis for childhood acute poststreptococcal glomerulonephritis (APSGN) is excellent when diagnosed and treated properly. Most children recover fully, showing normal kidney function and resolution of symptoms like hematuria and proteinuria.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Glomerular Diseases
Background:
- Recent studies suggest an improved prognosis for acute poststreptococcal glomerulonephritis (APSGN).
- Clarifying the current clinical course of APSGN is essential.
- Understanding APSGN prognosis aids in patient management and expectations.
Purpose of the Study:
- To analyze the clinical course and prognosis of childhood APSGN.
- To evaluate recovery rates and identify factors influencing outcomes.
- To confirm the generally excellent prognosis of APSGN.
Main Methods:
- Retrospective analysis of 220 children with acute nephritic syndrome from 1988-1997.
- Diagnosis of APSGN based on hematuria, hypocomplementemia, and evidence of streptococcal infection.
- Inclusion of 138 children specifically diagnosed with APSGN.
Main Results:
- No patients exhibited significant renal dysfunction (creatinine > or = 1.5 mg/dL).
- All patients had well-controlled blood pressure without persistent hypertension.
- Complete normalization of serum complement levels (100%) within 12 weeks, hematuria (100%) within 4 years, and proteinuria (100%) within 3 years.
Conclusions:
- Childhood APSGN demonstrates an excellent prognosis with adequate diagnosis and treatment.
- Rapid recovery of renal function and resolution of clinical signs are typical.
- Effective management ensures favorable long-term outcomes for affected children.
Background:
Recently, the prognosis of acute poststreptococcal glomerulonephritis (APSGN) has been reported as improved, compared with the results of previous studies. In an attempt to clarify this, we analyzed the clinical course of patients with APSGN.
Methods:
A total of 220 children with acute nephritic syndrome were treated in the affiliated hospitals of our department, between January 1988 and December 1997. Among them, 138 children who were diagnosed with APSGN according to the presence of hematuria, transient hypocomplementemia and evidence of group A beta-hemolytic streptococcal infection, were studied.
Results:
Serum creatinine and blood urea nitrogen levels at onset were 0.5 +/- 0.2 mg/dL and 20 +/-12 mg/dL, respectively. There were no patients with renal dysfunction (serum creatinine level > or = 1.5 mg/dL), but one patient with nephrotic syndrome. Blood pressure was well controlled in all patients and there were no patients with persistent hypertension. Serum complement levels were normalized within 12 weeks (100%), hematuria disappeared within 4 years (100%) and proteinuria disappeared within 3 years (100%) from the onset.
Conclusions:
These data indicate that the prognosis of APSGN during childhood is excellent, when adequately diagnosed and treated.
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