Clinical Spectrum and Outcome of Acute Post- infectious Glomerulonephritis in Children: A Hospital Based Study

Background: Post-infectious glomerulonephritis (PIGN) has a wide spectrum of clinical presentation and may mimic a wide variety of glomerular diseases. Aim: To evaluate, the clinical presentation, complications, and outcome of acute PIGN in children. Materials and Methods: A retrospective observational study of all children in the age group of 1-13 years who were diagnosed to have acute PIGN based on the clinical features, urine analysis, and C 3 levels admitted in Sri Manakula Vinayagar Medical College and hospital between January 2012 and December 2014 are included in this study. Case sheets were analyzed to obtain data on the clinical characteristics, laboratory parameters, complications, and outcome of these children. Descriptive analysis of the collected data was performed. Results: Out of 52 cases of PIGN, 88.4% the etiology was post-streptococcal. Pneumonia (11.5%) was another important cause identified. There was no difference in the occurrence between males and females, and the majority of cases (52%) are in the age group of 5-10 years. Among clinical features, hypertension was observed in 100% of the cases. Hematuria, oliguria, and edema were seen in 58%, 94%, and 90% of the children, respectively. Laboratory parameters include the presence of hematuria (100%) in all cases. Though mild proteinuria was seen in the majority of cases, nephrotic range proteinuria was observed in 11.5% of cases. The complications include acute kidney injury in 27%, congestive cardiac failure in 15%, hypertensive emergency in 23%, and encephalopathy in 7% of cases. No mortality was observed. Conclusion: Post-streptococcal glomerulonephritis is an important cause of acute PIGN. Children in the age group of 5-10 years are most affected. Acute kidney injury, congestive cardiac failure, and hypertensive encephalopathy are potential serious complications of this disease which requires intensive care monitoring to yield a positive outcome.