Clinical Characteristics and Outcome of Post-Infectious Glomerulonephritis in Children in Southern India: A Prospective Study.
Objectives: To evaluate the clinical characteristics, complications and outcome of post-infectious glomerulonephritis (PIGN).Methods: This prospective observational study was conducted from January 2013 through July 2014 at a tertiary care hospital in south India. Post-streptococcal glomerulonephrit...
| Publicado en: | Indian Journal of Pediatrics Vol. 82; no. 10; pp. 896 - 904 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109466598&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109466598 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00195456 1CQL jtl: Indian Journal of Pediatrics issn: 00195456 maglogo: N pubinfo: dt: Oct2015 vid: 82 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109466598 109466598 NLM25893528 109466598 10.1007/s12098-015-1752-0 NLM25893528 109466598 ppf: 896 ppct: 8 formats: tig: atl: Clinical Characteristics and Outcome of Post-Infectious Glomerulonephritis in Children in Southern India: A Prospective Study. aug: au: Gunasekaran, Kuralvanan Krishnamurthy, Sriram Mahadevan, Subramanian Harish, B. Kumar, Ajith Harish, B N Kumar, Ajith Prabhu affil: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006 India sug: subj: Kidney Pathology Streptococcal Infections Diagnosis Streptococcus Glomerulonephritis Diagnosis Female Kidney Failure, Acute Microbiology Prospective Studies Proteinuria Diagnosis Glomerulonephritis Microbiology Child Infant Tertiary Health Care Male India Prognosis Kidney Failure, Acute Diagnosis Streptococcal Infections Microbiology Hematuria Diagnosis Child, Preschool Adolescence Human Child: 6-12 years Infant: 1-23 months Child, Preschool: 2-5 years Adolescent: 13-18 years Female Male ab: Objectives: To evaluate the clinical characteristics, complications and outcome of post-infectious glomerulonephritis (PIGN).Methods: This prospective observational study was conducted from January 2013 through July 2014 at a tertiary care hospital in south India. Post-streptococcal glomerulonephritis (PSGN) was diagnosed in the presence of: a) Hematuria and proteinuria b) Clinico-serological evidence of recent streptococcal infection [recent pyodermas or pharyngitis; positive antistreptolysin-O (ASO) titres, anti-DNAse B titres or throat swab positivity for Group A streptococcus], and c) Low serum C3 levels, with normalization on 8 wk follow up. PIGN included PSGN and other infectious etiologies. AKI was classified as per Acute Kidney Injury Network (AKIN) criteria. Clinical features, biochemical and serological investigations in the study subjects were recorded.Results: Among 83 children with acute nephritic syndrome (ANS) recruited, 72 (86.7 %) had PIGN. PSGN was the most common etiology [65(90.3 %)] among the PIGN cases. Pyodermas, upper respiratory infections and varicella preceded hematuria in 58 (80.6 %), 4 (5.6 %) and 2 (2.8 %) cases respectively. Pneumonia, mumps and liver abscess caused PIGN in 7 (9.7 %) cases. Complications included AKI in 15 (20.8 %), hypertensive emergency in 14 (19.4 %), cardiac failure in 8 (11.1 %), encephalopathy in 3 (4.2 %) cases and retinopathy in 1 (1.4 %) case. Among the AKI patients, 3(20 %) were in AKI stage 3, while 1 child required hemodialysis. Twenty three cases (31.9 %) had evidence of residual renal injury at discharge. Renal biopsy showed diffuse proliferative glomerulonephritis in 4 and crescentic glomerulonephritis in one case of PIGN. At 6 mo follow up, one patient continued to have microalbuminuria.Conclusions: PIGN (including PSGN) remains a significant contributor to morbidity in children with ANS. The study is notable for high incidence of hypertensive emergency and AKI, that often required intensive care management. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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