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[The most frequent forms of acute glomerulonephritis in children. Epidemiology and prognosis]
Insights
This review examines common childhood kidney diseases: poststreptococcal glomerulonephritis (PSGN), IgA nephropathy (IgAGN), and Henoch-Schönlein purpura nephritis (HSGN). While PSGN often resolves, HSGN and IgAGN carry risks of progressive kidney failure over time.
Area of Science:
- Pediatric Nephrology
- Glomerular Diseases
- Renal Pathology
Background:
- Acute poststreptococcal glomerulonephritis (PSGN), idiopathic IgA nephropathy (IgAGN), and Henoch-Schönlein purpura nephritis (HSGN) are the most common pediatric glomerulonephritides.
- The true incidence of these conditions is unknown due to frequent asymptomatic presentations.
Purpose of the Study:
- To review the clinical characteristics and prognoses of PSGN, IgAGN, and HSGN in children.
- To highlight the long-term renal outcomes associated with these common pediatric kidney diseases.
Main Methods:
- Review of existing literature on pediatric glomerulonephritis.
- Analysis of age and sex distribution, disease progression, and renal failure incidence for PSGN, IgAGN, and HSGN.
Main Results:
- PSGN typically involves self-limited inflammatory lesions.
- IgAGN and HSGN share similar age and sex distributions.
- Renal failure can progress over time, particularly in HSGN and, to a lesser extent, IgAGN.
Conclusions:
- While PSGN generally has a favorable prognosis in children, IgAGN and HSGN present a higher risk of developing chronic kidney disease.
- Longer follow-up periods reveal an increasing frequency of renal failure in IgAGN and HSGN, underscoring the need for ongoing monitoring.
Abstract:
Acute poststreptococcal-(PSGN), idiopathic mesangial Ig-A-(IgAGN) and Henoch-Schönlein-glomerulonephritis (HSGN) have been selected for this review article as most frequent types of GN in children. Consequent to inapparent forms, the incidence of all three types is unknown. Age and sex distribution seem to be similar in IgAGN and HSGN. Active inflammatory parenchymal lesions are self limited in PSGN. However, in some children with HSGN and in very few with IgAGN progression to renal failure occurs. The longer the observation times, the better are the results of studies on prognosis in children with PSGN, whereas the frequency of renal failure in IgA- and particularly in HSGN increases with time.