Hemodynamic phenomena in acute glomerulonephritis

Fleisher, Daniel S.; Voci, G; Garfunkel, Joseph M.; Kirkpatrick, John; Wells, Christine; Purugganan, Hermogenes; McElfresh, Arthur E.

doi:10.1016/s0022-3476(65)81903-5

Cited by 3 publications

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“…1 It usually occurs after a recent infection by group A beta-hemolytic streptococcus, and therefore known as post-strepococcal acute glomerulonephritis (PSAGN). 2 Nevertheless, the disease has been reported following other bacterial, viral, parasitic, rickettsial, and fungal infections, 3 and known as non-poststreptococcal AGN (NPSAGN). AGN among Indonesian children seems to be less frequently reported than that among other countries.…”

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confidence: 99%

“…Although circulatory congestion is similar to primary fluid overload, there is no evidence of abnormality in the heart and blood vessel. 1,3,17 In other words, the generalized circulatory congestion is merely of renal origin. Complete recovery observed in our study ranged from 7 to 14 days with the majority of patients in 12 days; Iraqi patients mostly recovered within 2 weeks with average time of recovery 7.9 days 21 while Kashmiri children 7 days.…”

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The profile of acute glomerulonephritis among Indonesian children

Albar¹,

Rauf²

2016

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Background Acute glomerulonephritis (AGN) is a form of glom-erulonephritis characterized by sudden and explosive onset of glom-erular injury symptom. It usually occurs after recent infection bygroup A beta-hemolytic streptococcus. AGN among Indonesianchildren seems to be less frequently reported than that among othercountries.Objective To determine the current profile of AGN among Indo-nesian children hospitalized in eleven teaching centers.Methods This was a descriptive, cross-sectional study, based ona review of the standard medical records of 509 children with AGNhospitalized in 11 teaching centers in Indonesia over a five-yearperiod (1997-2002). Data extracted from the medical records con-sisted of history of illness, clinical and laboratory findings, and chestX-rays.Results Age of the patients at the onset of AGN ranged from 2.5 to15 years, with peak age of 8.5 years. The majority (76.4%) wasabove 6 years old with male predominance (58.3%). About 68.9%and 82% of the patients came from low socioeconomic and low edu-cational status families. Antecedent upper respiratory infections wereobserved in 45.8% cases and pyoderma in 31.6%. The diseaseseemed to be more commonly elicited by streptococcal infectionthan by other infections, as proved by an elevated anti-streptolisinO (ASO) titer (66.6%) and decreased C 3 concentrations (60.4%).The frequent clinical features included periorbital edema (76.3%),hypertension (61.8%), and gross hematuria (53.6%). The most preva-lent laboratory findings were microhematuria (99.3%), proteinuria(98.5%), raised erythrocyte sedimentation rate (85.3%). The initialchest X-rays showed pleural effusion (81.6%) and cardiomegaly(80.2%), whereas echocardiogram documented pericardial effusion(81.6%). Acute pulmonary edema (11.5%), hypertensive encepha-lopathy (9.2%), and acute renal failure (10.5%) were frequent com-plications noted in our study.Conclusion Despite no adequate data on throat or skin cul-tures, AGN among Indonesian children seems mostly to bepoststreptococcal AGN as proved by the elevated ASO titerand decrease in serum C 3 concentration

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The profile of acute glomerulonephritis among Indonesian children

Albar¹,

Rauf²

2016

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“…Gore and Saphir [7] found a serious type of myocarditis in 10% of patients with acute glomerulonephritis in a post-mortem pathological study. Later, Fleisher et al [5] performed cardiac catheterization in 10 children and found no myocardial failure. Balat et al [1] found impaired left ventricular function in some patients in the acute congestive phase of APGN, and suggested that it could influence the outcome of the disease.…”

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“…Heart function in children ill with APGN has been previously investigated in some studies, but using different study methods [5]. The advance of echocardiography has considerably improved the evaluation of LV dimensions and function.…”

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confidence: 99%

“…That belief was based on a post-mortem pathological study in which 10% of patients were found to have a serious type of myocarditis [7]. Since then, using cardiac catheterization, no myocardial failure was found [5]. Later, Balat et al [1], using echocardiography, noted that left ventricular function may be impaired in the acute congestive phase of APGN, and this may affect the course and prognosis of the disease.…”

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Echocardiographic findings in children ill with acute postinfectious glomerulonephritis

et al. 2003

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There are many studies about heart dysfunction and its significance in chronic renal diseases, but only few data regards cardiac involvement in acute glomerular diseases. The aim of this study was to assess echocardiographic changes in children with acute postinfectious glomerulonephritis (APGN), and the relationship of those changes to blood pressure (BP), edema and glomerular filtration rate (GFR). Echocardiography was performed on 127 patients on admission to the hospital, on a random sample consisting of 51 patients after 6-8 weeks, and 124 controls. In the acute phase, APGN patients had a greater left ventricular (LV) internal end-diastolic diameter (LVIDd) (P=0.022), interventricular septum thickness (IVSd) (P=0.038), LV mass (LVM) (P=0.0001), longer early diastolic flow deceleration time (DT) (P=0.0001), and higher numbers of cases with mitral regurgitation (MR) (P=0.0001) and pericardial effusion (P=0.0001) in comparison with the controls. Changes were more evident in the youngest patients. At follow-up after 6-8 weeks, echocardiographic parameters significantly improved, but LV posterior wall thickness, IVSd, LV end-diastolic volume, LVM and DT remained greater than in the controls. GFR and edema influenced echocardiographic parameters. In conclusion, in a group of children ill with APGN, increases in left ventricular dimensions, wall thickness, LVM and changes in the left ventricular diastolic function related to edema and GFR were found. Whether different treatment regimens effect these changes requires further study.

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Clinical Presentations and Outcome of Acute Glomerulonephritis in Children

Akteruzzaman¹,

Paul

Parveen

et al. 2019

Bangladesh Med J

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Acute post streptococcal glomerulonephritis (APSGN) is the most common type of acute glomerulonephritis (AGN) in childhood. It has not been studied well in Bangladesh. To evaluate the clinical characteristics, complications and outcome of Acute post streptococcal glomerulonephritis (AGN). the department of Pediatric Nephrology at Sir Salimullah Medical College and Mitford Hospital, Dhaka. A prospective study from April 2011 to March 2012 were conducted among the patients diagnosed as AGN in outdoor and indoor department. Hospital records of all 34 children who had been admitted to Sir Salimullah Medical College and Mitford Hospital were reviewed. All demographic, clinical, paraclinical data and consumed medications were obtained. Among 34 cases female and male ratio were 2.4:1; mean age of was 8.76 yrs. ± 2.5 SD and peak age 7.6. Etiology of AGN was post infectious glomerulonephritis (PIGN) 85.3%, ASO titer was raised in 88.2%, 41.2% had raised blood urea, and 32.4%raised serum creatinine level. All children presented with microscopic hematuria (100%), hypertension (100%), and edema (100%), other findings are fever (55.9%), oliguria (94.1%), abdominal pain (52.9%). History of sore throat and pyoderma was present in 41.2% and 44.1% cases respectively. Complications like hypertensive encephalopathy three (8.8%), urinary tract infection (UTI) one (2.9%) total seven (20%) were heart failure two (5.9%) and Acute kidney injury (AKI) one (2.9%), total seven (20%) were expired. Majority of cases manifest typically with edema, oliguria and hematuria. It usually has an uneventful course. Bangladesh Med J. 2019 Jan; 48 (1): 13-17

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Hemodynamic phenomena in acute glomerulonephritis

Cited by 3 publications

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The profile of acute glomerulonephritis among Indonesian children

The profile of acute glomerulonephritis among Indonesian children

Echocardiographic findings in children ill with acute postinfectious glomerulonephritis

Clinical Presentations and Outcome of Acute Glomerulonephritis in Children

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