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Acute glomerulonephritis in Kelantan--a prospective study.

F D'Cruz1, A T Samsudin, M S Hamid

  • 1Department of Paediatrics, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan.

The Medical Journal of Malaysia
|June 1, 1990
PubMed
Summary

This study on childhood acute nephritis found most cases stemmed from post-streptococcal infections, often following skin issues, and presented with severe complications like hypertension and edema.

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Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Immunology

Background:

  • Acute nephritis, specifically acute glomerulonephritis, is a significant pediatric renal disease.
  • Understanding the clinical patterns and etiological factors is crucial for effective management in children.
  • Socioeconomic factors may influence the incidence and presentation of childhood nephritis.

Purpose of the Study:

  • To investigate the clinical presentation and etiological profile of acute glomerulonephritis in Malaysian children.
  • To identify common preceding infections and assess the incidence of complications.
  • To determine the role of streptococcal infections using immunological markers.

Main Methods:

  • Prospective observational study involving 124 children admitted with acute glomerulonephritis.

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  • Data collection included clinical history, socioeconomic status, preceding infections (skin and throat), and complications.
  • Immunological investigations included Anti-Streptolysin O Titer (ASOT), anti-DNase B, and complement C3 levels.

    • Main Results:

    • The majority of patients (121/124) were diagnosed with post-streptococcal nephritis, predominantly following skin infections.
    • High rates of complications were observed, including severe hypertension (43.6%), pulmonary edema (36.3%), and severe azotemia (10.5%).
    • A significant proportion of families belonged to lower socioeconomic groups, with 54% below the poverty line.

    Conclusions:

    • Post-streptococcal glomerulonephritis is the primary cause of acute nephritis in this pediatric cohort, often linked to preceding skin infections.
    • The study highlights a high burden of severe complications, emphasizing the need for prompt diagnosis and management.
    • Lower socioeconomic status appears to be a contributing factor, suggesting a need for targeted public health interventions.