Clinical Profile Of Acute Glomerulonephritis In Children

Abstract

Background: Acute glomerulonephritis is one of the most common cause of acute renal failure in schooling population. AGN in children mostly has infectious origin but non infectious cause should also be kept in mind. Although deaths are rare, serious complications like hypertensive emergencies, encephalopathy, congestive cardiac failure, renal failure can occur.
Objective: This study attempts to evaluate the various clinical presentation, complications and
follow up of acute glomerulonephritis.
Material and Methods: This is a prospective observational study conducted over a period of one and a half year between January 2020 and July 2021 in children with confirmed clinical diagnosis of AGN admitted in pediatric ward of Indira Gandhi Institute of Child Health, Bengaluru.
Result: A total of 66 children were included in the study of which male children constituted 37
(56.1%) cases and 29 (43.9%) were females. Majority of the children were between age group of 6- 10 years with mean age being 8.9 years. 35 (53%) cases had history of preceding infection, with pyoderma being predominant seen in 27 (40.9%) cases and sore throat seen in 8 (12.1%) cases. The consistent complaint was edema, oliguria and hematuria. ASLO was positive in 30 (45.45%) cases. 65 (98.48%) cases had low C3 level at presentation. Renal biopsy was required in 16 (24.2%) cases. 39 (59%) cases developed complications and the most common was acute kidney injury seen in 17 (25.7%) cases followed by hypertensive encephalopathy in 15 (22.7%) cases. The most common etiology was PIGN seen in 53 (80.3%) cases others were SLE in 9 (13.6%) cases, MPGN in 3 (4.5%) cases, HSP nephritis in 1(1.5%) case. 12 (18.88%) cases had persistent low C3 level at 3 months follow up. Among 66 children with AGN, 39 (59.1%) children had complete recovery at 3 months and 58 (87.88%) children had complete recovery at 6 months in both clinical and laboratory parameters.
Conclusion: Early identification, monitoring for complications and early intervention is required to prevent morbidity and mortality. The study highlights the need for long term follow up to prevent end stage kidney disease.