Erythrocyturia and proteinuria conversion in post-streptococcal acute glomerulonephritis
Keywords:
Post-streptococcal acute glomerulonephritis, erythrocyturia, proteinuria
Abstract
Background Acute glomerulonephritis (AGN) is a sudden onsetof macroscopic hematuria and edema. The chronic post-strepto-
coccal acute glomerulonephritis (PSAGN) can be predicted if mi-
croscopic hematuria, proteinuria, and low serum complement C3
level are present for a period exceeding six months after initial onset
of illness. It is prudent to follow the course of PSAGN until proteinuria
normalizes and microhematuria disappears in urinalysis.
Objective To acquire the time of erythrocyturia and proteinuria
conversion in post-streptococcal acute glomerulonephritis (PSAGN)
among children.
Methods A retrospective cohort study on children with PSAGN
was conducted in the Pediatric Outpatient Clinic and Ward at
Sanglah Hospital, Denpasar, Bali from January 2001-December
2003. All subjects were recorded for clinical and laboratory signs,
including initial symptoms, history of previous streptococcal infec-
tions, blood pressure, complete blood count, serum albumin, ASTO
titer, complement C3 level, BUN, and serum creatinin. Erythrocyt-
uria and proteinuria follow-ups were done by recording urinalysis
findings for a six-month period after initial onset.
Results Thirty subjects 21 boys and 9 girls, mean age 8.7 (SD 2.5)
years] with PSAGN were enrolled in the study, 16 had hematuria with
edema. Twenty-one subjects had the history of upper respiratory tract
infections and 9 with skin infections. Mean systolic blood pressure was
141.3 (SD 21.8) mmHg, mean diastolic blood pressure was 90.8 (SD
16.3) mmHg, mean ASTO titer was 1103.3 (SD 686.1) IU/ml, and mean
complement C3 level was 42.2 (SD 15.5) mg/dl. Urinalysis monitoring
showed 2/30, 9/30, 12/30, 22/30, 27/30 subjects had conversion he-
maturia at the first, second, third, fourth, and fifth month, respectively.
Median duration of erythrocyturia conversion was 4.0 months (95% CI:
3.53-4.47). There were 11/30, 18/30, 21/30, 23/30, 25/30, 26/30 sub-
jects with proteinuria conversion at the first, second, third, fourth, fifth,
and sixth month, respectively. Median duration of proteinuria conver-
sion was 2.0 months (95% CI: 1.25-2.75).
Conclusion Three out of 30 children remained with persistent
hematuria and 4 of 30 remained with persistent proteinuria
References
1. Brouhard BH, Travis LB. Acute postinfectious glom-
erulonephritis. In: Edelmann CM, editor. Pediatric kid-
ney disease. 2nd ed. Boston: Little, Brown and Co;
1992. p. 1199-215.
2. Hricik DE, Chung-Park M, Sedor JR. Glomerulone-
phritis. N Engl J Med 1998;339:888-99.
3. Cunningham MW. Pathogenesis of group A Streptococ-
cal infection. Clin Microbiol Rev 2000;13(3):470-511.
4. Sardjito. Profile PSAGN in Indonesian children: a multi
center study. Proceedings of the 1 st Annual Pediatric
Meeting; 2001 June 25-27; Palembang, Indonesia.
5. Sarkissian A, Papazian M, Azatian G. An epidemic of
acute postinfectious glomerulonephritis in Armenia.
Arch Dis Child 1997;77:342-4.
6. Makker SP. Glomerular diseases. In: Kher KK, Makker
SP, editors. Clinical pediatric nephrology. 2nd ed. New
York: McGraw-Hill Inc; 1992. p. 212-20.
7. Sokolosky MC. Hematuria. Emerg Med Clin North Am
2001;19(3):621-32.
8. Vinen CS, Oliveira DBG. Acute Glomerulonephritis.
Postgrad Med J 2003;79:206-13.
9. Pardede SO, Trihono PP. Clinical features of acute
glomerulonephritis in children. Proceedings of the 12 th
National Child Health Congress; 2002 June 30-July 4;
Bali, Indonesia.
10. Travis LB, Kalia A. Acute nephritic syndrome. In:
Postlethwaite RJ, editor. Clinical paediatric nephrol-
ogy. 2nd ed. Oxford: Butterworth-Heinemann, 1994.
p. 201-9.
11. Mason PD. Fortnightly review: glomerulonephritis di-
agnosis and treatment. Br Med J 1994;309:1557-63.
12. Ninik AS. Long-term prognosis of post infectious glom-
erulonephritis after an acute episode. Proceedings of
the 12 th National Child Health Congress; 2002 June
30-July 4; Bali, Indonesia.
13. 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.
erulonephritis. In: Edelmann CM, editor. Pediatric kid-
ney disease. 2nd ed. Boston: Little, Brown and Co;
1992. p. 1199-215.
2. Hricik DE, Chung-Park M, Sedor JR. Glomerulone-
phritis. N Engl J Med 1998;339:888-99.
3. Cunningham MW. Pathogenesis of group A Streptococ-
cal infection. Clin Microbiol Rev 2000;13(3):470-511.
4. Sardjito. Profile PSAGN in Indonesian children: a multi
center study. Proceedings of the 1 st Annual Pediatric
Meeting; 2001 June 25-27; Palembang, Indonesia.
5. Sarkissian A, Papazian M, Azatian G. An epidemic of
acute postinfectious glomerulonephritis in Armenia.
Arch Dis Child 1997;77:342-4.
6. Makker SP. Glomerular diseases. In: Kher KK, Makker
SP, editors. Clinical pediatric nephrology. 2nd ed. New
York: McGraw-Hill Inc; 1992. p. 212-20.
7. Sokolosky MC. Hematuria. Emerg Med Clin North Am
2001;19(3):621-32.
8. Vinen CS, Oliveira DBG. Acute Glomerulonephritis.
Postgrad Med J 2003;79:206-13.
9. Pardede SO, Trihono PP. Clinical features of acute
glomerulonephritis in children. Proceedings of the 12 th
National Child Health Congress; 2002 June 30-July 4;
Bali, Indonesia.
10. Travis LB, Kalia A. Acute nephritic syndrome. In:
Postlethwaite RJ, editor. Clinical paediatric nephrol-
ogy. 2nd ed. Oxford: Butterworth-Heinemann, 1994.
p. 201-9.
11. Mason PD. Fortnightly review: glomerulonephritis di-
agnosis and treatment. Br Med J 1994;309:1557-63.
12. Ninik AS. Long-term prognosis of post infectious glom-
erulonephritis after an acute episode. Proceedings of
the 12 th National Child Health Congress; 2002 June
30-July 4; Bali, Indonesia.
13. 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.
Published
2016-10-18
How to Cite
1.
Suarta I. Erythrocyturia and proteinuria conversion in post-streptococcal acute glomerulonephritis. PI [Internet]. 18Oct.2016 [cited 22Nov.2024];46(2):71-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/904
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Received 2016-10-13
Accepted 2016-10-13
Published 2016-10-18
Accepted 2016-10-13
Published 2016-10-18
