The profile of acute glomerulonephritis among Indonesian children
Keywords:
acute glomerulonephritis, poststreptococcal glomerulonephritis, Indonesian children
Abstract
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 by
group A beta-hemolytic streptococcus. AGN among Indonesian
children seems to be less frequently reported than that among other
countries.
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 on
a review of the standard medical records of 509 children with AGN
hospitalized in 11 teaching centers in Indonesia over a five-year
period (1997-2002). Data extracted from the medical records con-
sisted of history of illness, clinical and laboratory findings, and chest
X-rays.
Results Age of the patients at the onset of AGN ranged from 2.5 to
15 years, with peak age of 8.5 years. The majority (76.4%) was
above 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 were
observed in 45.8% cases and pyoderma in 31.6%. The disease
seemed to be more commonly elicited by streptococcal infection
than by other infections, as proved by an elevated anti-streptolisin
O (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 initial
chest 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 be
poststreptococcal AGN as proved by the elevated ASO titer
and decrease in serum C 3 concentration
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Wel LG, editors. Disease of the kidney. 2nd ed. Bos-
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Babloyan A, Leumann E. An epidemic of acute
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phritis in Kashmiri children-a clinical and epidemio-
logical profile. Indian Pediatr 1979;16:1015-21.
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Caryajal HF, DeBeukelaer MM, et al. Poststreptococcal
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15. Puri RK, Khanna KK, Raghu MB. Acute glomerulo-
nephritis in children. Indian Pediatr 1976;3:707-10.
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and Wilkins company; 1975. p. 530-45.
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erulonephritis. In: Edelmann CM, editor. Pediatric kid-
ney disease. 2nd ed. Boston: Little Brown and com-
pany; 1992. p. 1199-215.
18. James AJ. Renal disease in childhood. 2nd ed. St Louis:
Mosby company; 1972. p. 175-85.
19. Roy S, Stapleton FB. Changing perspective in children
hospitalized with poststreptococcal acute glomerulo-
nephritis. Pediatr Nephrol 1990;4:585-8.
20. Kirkpatrick JA, Fleischer DS. The roentgen appear-
ance of the chest in acute glomerulonephritis in chil-
dren. J Pediatr 1964;64:492-8.
21. Al-Mosawi AJ. The pattern of acute glomerulonephri-
tis in 47 Iraqi children. Pediatr Nephrol 2002;17:74-5.
Postlethwaite, editor. Clinical paediatric nephrology.
2nd ed. ButterWorth-Heinamann Ltd. Linacre House:
Jordan Hill; 1994. p. 201-9.
2. Behrman RE, Kliegman R. Acute poststreptococcal
glomerulonephritis. In: Nelson’s essentials of pediat-
rics. Philadelphia: WB Saunders and company; 1990.
p. 566-7.
3. Fleisher DS, Voci G, Garfunkel J, Purungganan H,
Kirkpatrick JJ, Wells R, et al. Hemodynamic findings in
acute glomerulonephritis. J Pediatr 1966;69:1054-62.
4. Jordan SC, Lemire JM. Acute glomerulonephritis.
Pediatr Clin North Am 1982;29:857-73.
5. Kobrin S, Madaio MP. Postinfectious glomerulonephri-
tis. In: Schier RW, Gottschalk CW, editors. Diseases of
the kidney. Boston: Little Brown and company; 1997.
p. 1579-94.
6. Report of the 2nd task force on blood pressure control
in children. Pediatrics 1987;79:1.
7. Lewy JE. Acute poststreptococcal glomerulonephritis.
Pediatr Clin North Am 1976;23:751-8.
8. Barrat TM. Glomerular disease and hematuria. In: Wil-
liam DI, Johnson JH, editors. Pediatric urology. 2nd
ed. London: Butterworth company; 1982. p. 87.
9. Vogt A. Postinfectious and autoimmune glomerulone-
phritis: Are cationic antigens involved? Act med Bio
1991;39:17-29.
10. Schwartz WB, Kassrer JP. Clinical aspects of acute
poststreptococcal glomerulonephritis. In: Strauss MB,
Wel LG, editors. Disease of the kidney. 2nd ed. Bos-
ton: Little Brown and company; 1971. p. 419-52.
11. Ibadin OM, Abiodun O. Childhood acute glomerulo-
nephritis in Benin City. Nigerian Journal of Pediatrics
2003;30:45-9.
12. Sarkissian A, Papazian M, Azatian G, Arikiants N,
Babloyan A, Leumann E. An epidemic of acute
postinfectious glomerulonephritis in Armenia. Arch
Dis Child 1997;77:342-4.
13. Manhas RS, Patwari A, Raina C, Singh A. Acute ne-
phritis in Kashmiri children-a clinical and epidemio-
logical profile. Indian Pediatr 1979;16:1015-21.
14. Dodge WF, Spargo BH, Travis LB, Srivastava RN,
Caryajal HF, DeBeukelaer MM, et al. Poststreptococcal
glomerulonephritis. A prospective study in children.
N Engl J Med 1972;286:273-8.
15. Puri RK, Khanna KK, Raghu MB. Acute glomerulo-
nephritis in children. Indian Pediatr 1976;3:707-10.
16. Rubin MI. Glomerulonephritis. In: Rubin MI, Barret
TM, editors. Pediatric nephrology. Baltimore: Williams
and Wilkins company; 1975. p. 530-45.
17. Brouhard BH, Travis LB. Acute postinfectious glom-
erulonephritis. In: Edelmann CM, editor. Pediatric kid-
ney disease. 2nd ed. Boston: Little Brown and com-
pany; 1992. p. 1199-215.
18. James AJ. Renal disease in childhood. 2nd ed. St Louis:
Mosby company; 1972. p. 175-85.
19. Roy S, Stapleton FB. Changing perspective in children
hospitalized with poststreptococcal acute glomerulo-
nephritis. Pediatr Nephrol 1990;4:585-8.
20. Kirkpatrick JA, Fleischer DS. The roentgen appear-
ance of the chest in acute glomerulonephritis in chil-
dren. J Pediatr 1964;64:492-8.
21. Al-Mosawi AJ. The pattern of acute glomerulonephri-
tis in 47 Iraqi children. Pediatr Nephrol 2002;17:74-5.
Published
2016-10-13
How to Cite
1.
Albar H, Rauf S. The profile of acute glomerulonephritis among Indonesian children. PI [Internet]. 13Oct.2016 [cited 27Apr.2024];45(6):264-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/884
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Received 2016-10-12
Accepted 2016-10-12
Published 2016-10-13
Accepted 2016-10-12
Published 2016-10-13
