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Delay in diagnosis in poststreptococcal glomerulonephritis

Priya J Pais1, Theresa Kump, Larry A Greenbaum

  • 1Department of Pediatrics, Medical College of Wisconsin and Children's Research Institute of Children's Hospital of Wisconsin, Milwaukee, WI, USA.

The Journal of Pediatrics
|June 7, 2008
PubMed

Insights

Diagnostic delays are common in children with poststreptococcal glomerulonephritis (PSGN), particularly when gross hematuria is absent. Early urinalysis is crucial for timely diagnosis of this kidney condition.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases

Background:

  • Poststreptococcal glomerulonephritis (PSGN) is a significant cause of acute kidney injury in children.
  • Timely diagnosis of PSGN is essential to prevent complications and ensure appropriate management.

Purpose of the Study:

  • To investigate the incidence and identify risk factors associated with delayed diagnosis in pediatric PSGN cases.
  • To improve early detection strategies for PSGN in children.

Main Methods:

  • Retrospective chart review of 52 children diagnosed with PSGN.
  • Statistical analysis, including univariate and multivariate logistic regression, to identify risk factors for diagnostic delays exceeding 24 hours.

Main Results:

  • A diagnostic delay occurred in 33% of children with PSGN.
  • Absence of gross hematuria as a presenting symptom significantly increased the risk of diagnostic delay (3.8-fold increased relative risk).
  • Children with a negative infection history were more likely to experience diagnostic delays.

Conclusions:

  • Diagnostic delays are prevalent in pediatric PSGN, especially when gross hematuria is not an initial sign.
  • Physicians should maintain a high index of suspicion for PSGN in children presenting with symptoms potentially related to volume overload.
  • Urinalysis serves as a valuable initial tool for diagnosing PSGN.
Abstract

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