Acute Glomerulonephritis in Children: A Hospital-Based Study in a Tertiary Care Centre in Nepal

Abstract

Background: Acute glomerulonephritis is a common pediatric kidney disease which places a huge burden in developing countries. This study aimed to evaluate causes, clinical manifestations, laboratory findings and complications of acute glomerulonephritis in children presented to a tertiary care center of Nepal. Methods: This was a retrospective review of records of children admitted with acute glomerulonephritis at Chitwan Medical College from April 2018 to February 2021. Socio-demographic data, clinic-laboratory profile and outcomes were obtained from medical records and descriptive analysis was carried out. Results: Among 48 recruited children with acute glomerulonephritis, 60.4% were male and the mean age was 9.5 ± 3.7 years. Post infectious glomerulonephritis including post streptococcal glomerulonephritis (48%) was the main cause of acute glomerulonephritis. The major clinical features were edema (81.3%), hypertension (72.9%), dyspnea (29.2%) and hematuria (25%). ASO titer was positive in 45.8%. The complications noted were acute kidney injury (6.3%), hypertensive emergency (6.3%) and congestive cardiac failure (2.1%). Conclusions: Most of the patients were above 5 years of age and presented most commonly during autumn and summer season. The complications of acute glomerulonephritis were acute kidney injury, hypertensive emergency and congestive cardiac failure.

Acute Post-infectious Glomerulonephritis in Children Admitted to a Tertiary Care Hospital: A Descriptive Cross-sectional Study

“…Among 6 cases, throat swab was positive for Group A streptococcus in 3 (50%). [6][7][8][12][13][14] These observations were in accordance with the other studies. 7,[12][13][14] Glomerulonephritis is least common in very early age may be due to immature immune response in early age.…”

“…Acute post-infectious glomerulonephritis (APIGN) is common in age group of 5-14 year age, predominantly in males with ratio of 1.86:1.3, and is very rare with <5% below 2 years of age while, in the present study the youngest one was 1 year old and the children below 5 years of age is about 19.02%. 6 - 8 , 12 - 14 These observations were in accordance with the other studies. 7 , 12 - 14 Glomerulonephritis is least common in very early age may be due to immature immune response in early age.…”

“… 6 - 8 , 12 - 14 These observations were in accordance with the other studies. 7 , 12 - 14 Glomerulonephritis is least common in very early age may be due to immature immune response in early age. 9 Another explanation for the relatively high rate of toddlers may be the increasing incidence of streptococcal infection or possibly other infectious triggers in this population.…”

“…Microscopic haematuria was found in 93.65%, which was similar to other studies. 3 , 6 - 8 , 12 , 13 As per another study, incidence of AKI in patients with PIGN reported 21.40%, while in our study 3.17% of all cases had deranged renal function which was much lower than other previous studies. 15 The proportion of proteinuria was 31.74% in patient with PIGN, among them 28.57% of all our cases had sub nephrotic range proteinuria and 3.17% of all cases had nephrotic range proteinuria, which was similar to study done by Gunasekaran et al, 13 while the various studies reported 17%, 14% and 6.67% of all cases had nephrotic range proteinuria, which were much higher than our study.…”

“…15 However it was similar to some studies and other clinical features of PIGN as vomiting, dyspnoea, headache, pain abdomen, seizure, and rashes were in accordance to others study. 3 , 8 , 12 …”