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Acute glomerulonephritis in children: a prospective study
Insights
Acute glomerulonephritis (AGN) is common in Thai children, often presenting with edema and hypertension. Prompt treatment leads to a very good prognosis, with most patients recovering fully within a year.
Area of Science:
- Pediatrics
- Nephrology
- Infectious Diseases
Background:
- Acute glomerulonephritis (AGN) is a significant kidney disease in children.
- Streptococcal infections are a common cause of AGN.
- Understanding the clinical course and prognosis of AGN is crucial for pediatric care.
Purpose of the Study:
- To prospectively study the clinical features, serologic findings, and outcomes of acute glomerulonephritis in children in Thailand.
- To evaluate the short-term and long-term prognosis of pediatric AGN.
Main Methods:
- Prospective study of 56 pediatric patients diagnosed with acute glomerulonephritis in 1984.
- Clinical data collection including age, symptoms (edema, hypertension, hematuria, proteinuria), and laboratory findings (serum complement, BUN, Scr).
- Serologic testing for streptococcal infection and microbial cultures were performed.
Main Results:
- The peak age for AGN was 5-9 years, with common symptoms including edema, hypertension, and hematuria.
- Streptococcal infection was serologically confirmed in 68% of cases.
- Edema and hypertension resolved within 2 weeks; renal function normalized by one year, with most patients showing complete recovery by the fourth year.
Conclusions:
- Acute glomerulonephritis remains a prevalent pediatric kidney disease in Thailand.
- The study highlights a favorable prognosis for pediatric AGN with timely and appropriate medical management.
- Long-term follow-up indicates sustained recovery and minimal residual renal impairment in most cases.
Abstract:
Fifty-six patients with acute glomerulonephritis were studied prospectively during 1984. Their ages ranged from 10 months to 14 years old with the peak age range between 5 to 9 years. Most of them had edema, hypertension, hematuria with or without proteinuria and had low serum complement. Azotemia was found in 45 per cent of the cases. Serologic evidence for streptococcal infection was positive in 68 per cent and only 6 per cent had positive culture. Edema and hypertension were all resolved within 2 weeks. All patients that were followed up had normal serum complement by the 6th week, normal BUN, Scr by one year. The hematuria disappeared by 6 months and proteinuria by 2 months in 50 per cent of the cases. By the 4th year only one patient had microscopic hematuria and mild proteinuria with normal serum creatinine, normotension and no edema. In conclusion, in Thailand AGN is still a common kidney disease in children but with prompt and proper treatment its prognosis is still very good.