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Prognosis of post-streptococcal glomerulonephritis: Chandigarh study
Annals of the Academy of Medicine, Singapore
|January 1, 1982
Summary
Acute post-streptococcal glomerulonephritis can lead to end-stage renal failure in 17% of patients within two years, with an additional 8% progressing over the next decade. Adult patients face a higher risk of severe outcomes and mortality.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Immunology
Background:
- Acute post-streptococcal glomerulonephritis (APSGN) is a significant cause of kidney disease, particularly in children and young adults.
- Understanding the long-term prognosis of APSGN is crucial for patient management and public health strategies.
Purpose of the Study:
- To investigate the long-term outcomes and progression of acute post-streptococcal glomerulonephritis in a North Indian population.
- To identify factors associated with poor prognosis and end-stage renal failure in APSGN patients.
Main Methods:
- A ten-year follow-up study of 144 hospitalized patients (107 adults, 37 children) with APSGN.
- Clinical data collection including proteinuria, hypertension, renal insufficiency, hematuria, and renal histology (glomerular crescents).
Main Results:
- 17% of patients progressed to end-stage renal failure within 2 years; an additional 2% progressed within 10 years.
- Adult patients had a higher mortality rate (26/107) compared to children (2/37).
- Persistence of nephrotic state, hypertension, renal insufficiency, and glomerular crescents were linked to poor outcomes.
Conclusions:
- APSGN can lead to significant long-term renal morbidity and mortality, especially in adults.
- Early identification of risk factors like persistent proteinuria, hypertension, and specific histological findings is vital for predicting outcomes.
- A substantial proportion of patients may progress to end-stage renal failure beyond 10 years, necessitating long-term monitoring.