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Acute glomerulonephritis in children: a review of 153 cases
Abstract:
Clinical experience with 153 cases of acute glomerulonephritis is recorded. Streptococcal impetigo was the major causative factor in this series. The acute fatality rate was 1.3% (two patients). Of the 151 survivors, 103 patients have been followed up for periods of six months to 11 years. None of these patients have shown any evidence of progression to chronic glomerulonephritis. In this series, as in others previously reported, acute glomerulonephritis in children appears to be self-limited in contrast to the illness in adults, where 25% to 40% of the cases progress to chronic glomerulonephritis. Unusual findings in this survey were ten patients with minimal or no urine abnormalities. Ten patients had normal serum complement values and three patients had well documented second attacks of poststreptococcal glomerulonephritis.
Insights
Acute glomerulonephritis in children, often caused by streptococcal impetigo, appears self-limiting. Long-term follow-up of survivors showed no progression to chronic kidney disease, unlike in adults.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Infectious Diseases
Background:
- Acute glomerulonephritis (AGN) is a significant kidney disease.
- Post-streptococcal glomerulonephritis is a common form, particularly in children.
- Understanding the long-term prognosis of AGN is crucial for patient management.
Purpose of the Study:
- To evaluate the clinical course and long-term outcomes of acute glomerulonephritis in a pediatric cohort.
- To identify causative factors and assess the progression to chronic kidney disease.
Main Methods:
- Retrospective analysis of 153 pediatric cases of acute glomerulonephritis.
- Identification of causative agents, with a focus on streptococcal infections.
- Long-term follow-up of survivors to monitor for progression to chronic glomerulonephritis.
Main Results:
- Streptococcal impetigo was the primary cause of AGN in this series.
- The acute fatality rate was 1.3%.
- None of the 103 followed survivors showed progression to chronic glomerulonephritis, suggesting a self-limited course in children.
Conclusions:
- Pediatric acute glomerulonephritis, especially post-streptococcal, has a favorable prognosis and is typically self-limited.
- Findings contrast with adult cases where progression to chronic disease is more common.
- Further research into atypical presentations and recurrent episodes is warranted.