Prognostic factors for mortality in pediatric acute poststreptococcal glomerulonephritis

  • Syamsul Nur Department of Child Health, Hasanuddin University Medical School, Makassar
  • Husein Albar Department of Child Health, Hasanuddin University Medical School, Makassar
  • Dasril Daud Department of Child Health, Hasanuddin University Medical School, Makassar
DOI: https://doi.org/10.14238/pi56.3.2016.166-70
Keywords: glomerulonephritis, streptococcus, prognostic, children

Abstract

Background Acute post-streptococcal glomerulonephritis (APSGN) is one of the most common causes of glomerular disease in developing countries, including Indonesia. It can lead to end stage renal failure and higher mortality rates. To decrease morbidity and mortality, it is important to understand the prognostic factors affecting the disease.
Objective To identify prognostic factors affecting outcomes in pediatric APSGN patients.
Methods Study data were collected from medical records of patients with APSGN hospitalized in Wahidin Sudirohusodo Hospital, Makassar in 2009-2013. Possible prognotic factors analyzed were gender, age, nutritional status, level of consciousness, as well as proteinuria, hemoglobin, serum albumin, urea, and creatinine levels.
Results Of 86 subjects, 82 (95.3%) survived and 4 (4.7%) died. Fifty-three (61.6%) patients were male and 33 (38.4%) were female. Subjects’ ages ranged from 3.42 to 14.67 years, with a mean age of 9.36 years. Multivariate analysis revealed serum creatinine level >1.5 mg/dL to be an independent prognostic factor for mortality in children with APSGN (AOR 15.43; 95%CI 1.31 to 181.7; P=0.03).
Conclusion High serum creatinine level is an independent prognostic factor for poor outcomes in children with APSGN. [Paediatr Indones. 2016;56:166-70.].

References

1. Wong W. Glomerulonephritis-acute in children. Starship Children’s Health Clinical Guideline. 2009. [cited 5 October 2014]; p. 1-3.. Available from: http://www.adhb.govt.nz/starshipclinicalguidelines/_Documents/Glomerulonephritis.pdf.
2. Ho CZ, Chen YH. The clinical analysis of acute glomerulonephritis and nephrotic syndrome in Chinese children. J Med Sci. 1995;15:429-40.
3. Mossie L, Shimelis D. Outcome of children with acute post streptococcal glomerulonephritis in Tikur Anbessa specialized teaching hospital. Ethiopian J Pediatr Child Health. 2012;8:1-16.
4. Steer AC, Danchin MH, Carapetis JR. Group A streptococcal infections in children. J Paediatr Child Health. 2007;43:203-13.
5. White AV, Hoy WE, McCredie DA. Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life. Med J Aust. 2001;174:492-6.
6. Kumar GV. Clinical study of post-streptococcal glomerulonephritis in children with special reference to presentation. Current Pediatr Res. 2011;15:89-92.
7. Etuk IS, Anah MU, Eyong ME. Epidemiology and clinical features of glomerulonephritis in Calabar, Nigeria. Niger J Physiol Sci. 2009;24:91-4.
8. Albar H, Rauf S. The profile of acute glomerulonephritis among Indonesian children. Paediatr Indones. 2005;45:264-9.
9. Sepahi MA, Shajari A, Shakiba M, Shooshtary FK, Salimi MH. Acute glomerulonephritis: a 7 years follow up of children in center of Iran. Acta Med Iran. 2011;49:375-8.
10. Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: an update. Curr Opin Pediatr. 2008;20:157-62.
11. Bingler MA, Ellis D, Moritz ML. Acute post-streptococcal glomerulonephritis in 14-month-old-boy: why is this uncommon? Pediatr Nephrol. 2007;22:448-50.
12. Nissenson AR, Baraff LF, Fine RN, Knutson DW. Poststreptococcal acute glomerulonephritis: fact and controversy. Ann Intern Med. 1979;91:76-86.
13. Tasic V, Polenakovic M. Thrombocytopenia during the course of acute poststreptococcal glomerulonephritis. Turk J Pediatr. 2003;45:148-51.
14. Rodriguez-Iturbe B. Acute postinfectious glomerulonephritis. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa, editors. Pediatric nephrology. 6th ed. Berlin: Springer; 2009. p. 743-55.
15. Suarta IK. Erythrocyturia and proteinuria conversion in post-streptococcal acute glomerulonephritis. Paediatr Indones. 2006;46:71-6.
Published
2016-07-01
How to Cite
1.
Nur S, Albar H, Daud D. Prognostic factors for mortality in pediatric acute poststreptococcal glomerulonephritis. PI [Internet]. 1Jul.2016 [cited 23Dec.2024];56(3):166-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/232
Issue
Vol 56 No 3 (2016): May 2016
Section
Pediatric Nephrology

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Received 2016-08-18
Accepted 2016-08-18
Published 2016-07-01