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
References
1. Travis LB, Kalian. Acute nephritic syndrome. In:
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.
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 25Nov.2024];45(6):264-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/884
Section
Articles
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 2016-10-12
Accepted 2016-10-12
Published 2016-10-13
Accepted 2016-10-12
Published 2016-10-13
