Clinical outcome of acute poststreptococcal glomerulonephritis [APSGN] in Iranian children

ABSTRACT

Recently, the prognosis of acute post-streptococcal glomerulonephritis [APSGN] has been reported as improved compared with the results of previous studies. In an attempt to clarify this in Iranian children, we analyzed the clinical course of patients with APSGN. In this retrospective study, a total of 53 children diagnosed as having APSGN according to the presence of hematuria and/or proteinuria, evidence of group A beta-hemolytic streptococcal infection, transient hypocomplementemia and absence of clinical or histological evidence of previous renal disease were studied in our department between March 1986 to September 2002. Fifty-three children, 19 females and 34 males, aged 3-13 years [mean 8.7 years] were enrolled in the study. All children had hematuria, proteinuria and decreased serum complement. There were no patients with renal dysfunction, but one case with nephritic syndrome. Forty-three [81%] had hypertension according to Second Task Force criteria. Blood pressure [BP] was normal in the remaining 10 [19%] patients. Eight children were lost for the follow-up examination. Two patients received renal biopsy. Both biopsies were abnormal showing mild changes with corresponding immunologic findings. Forty-five children were reassessed after an average of 5 months [range 1 month to 66 months]. At the last follow-up all of these children were in good physical health. The BP, serum creatinine, and complement levels were within normal limits. These findings indicated that the prognosis of APSGN during childhood is excellent, when adequately recognized and received supportive measures in the treatment, including control of high blood pressure and chemical imbalance in acute phase of disease. Additionally, according to our results, we could predict a favorable prognosis and reassure the family