Acute poststreptococcal glomerulonephritis: the most common acute glomerulonephritis.
On the basis of strong research evidence, the prevalence of poststreptococcal glomerulonephritis (PSGN) is decreasing worldwide, although it still remains the leading cause of glomerulonephritis in children. The overall decrease in prevalence of PSGN has been mainly driven by a significant decrease...
| Publicado en: | Pediatrics in Review Vol. 36; no. 1; pp. 3 - 14 |
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| Autores principales: | , |
| Formato: | case study review Journal Article |
| Publicado: |
American Academy of Pediatrics
Jan2015
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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=109691360&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109691360 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01919601 10RG jtl: Pediatrics in Review issn: 01919601 maglogo: N pubinfo: dt: Jan2015 vid: 36 iid: 1 pid: 1659 pub: American Academy of Pediatrics place: Elk Grove Village, Illinois artinfo: ui: 109691360 109691360 NLM25554106 2012869829 10.1542/pir.36.1.3 NLM25554106 109691360 ppf: 3 ppct: 11 formats: tig: atl: Acute poststreptococcal glomerulonephritis: the most common acute glomerulonephritis. aug: au: VanDeVoorde 3rd, René G VanDeVoorde, René G 3rd affil: Division of Pediatric Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH sug: ab: On the basis of strong research evidence, the prevalence of poststreptococcal glomerulonephritis (PSGN) is decreasing worldwide, although it still remains the leading cause of glomerulonephritis in children. The overall decrease in prevalence of PSGN has been mainly driven by a significant decrease in pyoderma seen in the last half-century, such that postpharyngitic PSGN is most commonly seen in developed nations. On the basis of primarily consensus because of a lack of relevant clinical studies, the latency period between streptococcal infection and the development of nephritis is a hallmark of PSGN, with this period lasting 1 to 2 weeks with pharyngeal infections or 2 to 6 weeks with skin infections. Concurrent infectious and nephritis symptoms should elicit further suspicion of other causes of glomerulonephritis. On the basis of expert opinion, PSGN is one of a handful of nephritic disorders with hypocomplementemia (low C3 level). The decrease in C3 is found in more than 90% of PSGN cases and is typically seen earlier than an increase in antistreptolysin O titers. Measuring C3 and C4 may also be helpful in the evaluation of other causes of acute nephritis. On the basis of primarily consensus because of a lack of relevantclinical studies, the main sequelae of PSGN (hypertension, edema,gross hematuria, and impaired renal function) are greatest in thefirst 7 to 10 days of disease. Therefore, this period requires themost vigilance for adverse effects. On the basis of some research evidence and consensus, the most effective treatment of hypertension and edema in PSGN is loop or thiazide diuretics, which may also address hyperkalemia. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may be effective in hypertension control but carry the risk of hyperkalemia and temporarily impairing recovery of renal function. On the basis of some research evidence and consensus, the prognosis for PSGN, even long term, is good. Despite being the most prevalent of the childhood glomerulonephritides, it often does not cause chronic kidney disease, but persistent microscopic hematuria and proteinuria may be seen in less than 10% of patients. pubtype: Academic Journal doctype: case study review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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