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- Title
Pediatric post‐streptococcal glomerulonephritis: Clinical and laboratory data.
- Authors
Demircioglu Kılıc, Beltinge; Akbalık Kara, Mehtap; Buyukcelik, Mithat; Balat, Ayse
- Abstract
Abstract: Background: Acute post‐streptococcal glomerulonephritis (APSGN) is the most common post‐infectious glomerulonephritis in childhood. The aim of this study was therefore to identify the possible risk factor(s) responsible for decreased glomerular filtration rate (GFR) in APSGN. Methods: The data of patients followed up with a diagnosis of APSGN in the Pediatric Nephrology Clinic of Gaziantep University Hospital between October 2014 and October 2016 were retrospectively evaluated. Results: The total number of subjects was 75 (male/female, 42/33) with a mean age of 8.20 ± 3.25 years. The most common presentations were edema (86.7%), macroscopic hematuria (82.7%) and hypertension (73.3%, n = 55). On laboratory examination, 28 children (37.3%) had hypoalbuminemia, 58 (77.3%) had proteinuria, 20 (26.7%) had increased C‐reactive protein (CRP), while 74 (98.7%) and 12 (16%) had decreased complement (C)3 and C4, respectively. The number of children with GFR <90 mL/min/1.73 m2 was 22 (29.3%). The risk of decreased GFR was significantly higher in patients with increased CRP (P = 0.001; OR, 3.58), hypoalbuminemia (P = 0.006; OR, 4.83), and decreased C4 (P = 0.010; OR, 11.53). Additionally, white blood cell (WBC) count, neutrophil count, and neutrophil/lymphocyte ratio (NLR) were significantly higher (P = 0.02, P = 0.006, P = 0.004, respectively) in patients with low GFR. Conclusions: Although the prognosis of APSGN in children is good, severe systemic complications and renal failure may develop during the follow‐up period. Decreased C4, presence of hypoalbuminemia, and increased inflammatory markers (WBC, CRP, neutrophil count and NLR) might be possible risk factors for severity of renal involvement. Decreased C4, in particular, may be a risk factor for decreased GFR in those children.
- Subjects
ACUTE kidney failure; BLOOD protein disorder diagnosis; DIAGNOSIS of edema; HEMATURIA diagnosis; PROTEINURIA diagnosis; HYPERTENSION; ACADEMIC medical centers; BIOMARKERS; C-reactive protein; COMPLEMENT (Immunology); GLOMERULAR filtration rate; INFLAMMATORY mediators; GLOMERULONEPHRITIS; NEUTROPHILS; RISK assessment; STREPTOCOCCAL diseases; RETROSPECTIVE studies; SEVERITY of illness index; LEUKOCYTE count; LYMPHOCYTE count; ODDS ratio; DISEASE complications; PROGNOSIS; DIAGNOSIS; DISEASE risk factors
- Publication
Pediatrics International, 2018, Vol 60, Issue 7, p645
- ISSN
1328-8067
- Publication type
Article
- DOI
10.1111/ped.13587