A 6-year review of acute post-streptococcal glomerulonephritis at a public children's hospital in Cape Town, South Africa.

Autor: Abugrain K; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Division of Paediatric Nephrology, Red Cross War Memorial Children's Hospital, Klipfontein Road, Cape Town, 7700, South Africa., McCulloch MI; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. Mignon.mcculloch@uct.ac.za.; Division of Paediatric Nephrology, Red Cross War Memorial Children's Hospital, Klipfontein Road, Cape Town, 7700, South Africa. Mignon.mcculloch@uct.ac.za., Muloiwa R; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa., Luyckx VA; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.; Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland., Buys H; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Division of Ambulatory and Emergency Paediatrics, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Jun; Vol. 39 (6), pp. 1809-1816. Date of Electronic Publication: 2024 Jan 03.
DOI: 10.1007/s00467-023-06247-8
Abstrakt: Background: Acute post-streptococcal glomerulonephritis (APSGN) is the most common cause of acute nephritis in children globally and, in some cases, may be associated with progressive kidney injury and failure, cumulating in the need for long-term dialysis and/or kidney transplantation.
Methods: Our retrospective study describes the occurrence of APSGN among children (< 14 years) admitted to a tertiary children's hospital in Cape Town, South Africa, from January 2015 to December 2020.
Results: Of 161 children who presented with acute nephritis (haematuria, oedema, oliguria, and hypertension), 100 met the inclusion criteria. Demographic, clinical features, laboratory findings, management, and outcome data were collected. APSGN was defined by the clinical presentation of at least two clinical signs of acute nephritis, and low serum complement 3 (C3) level or evidence of a recent streptococcal infection. Most cases of APSGN were associated with streptococcal skin infections: 55/100 (55%); 10/100 (10%) children presented with hypertensive seizures; C3 levels were low in 86/92 (93.5%) children; 94/94 (100%) children had elevated anti-deoxyribonuclease-B (anti-DNase-B) levels; and 80/94 (85%) also had elevated anti-streptolysin O titre (ASOT) at presentation. Eleven (11%) children had a percutaneous kidney biopsy; 4/11 (36%) showed histological features of post-infectious nephritis, and 7/11(64%) also had crescentic glomerulonephritis with immune complex deposits. Sixty-two (62%) children confirmed recovered, and five (5%) progressed to kidney failure, but 29 presumed recovered as they did not return for follow-up to our institution.
Conclusions: Childhood APSGN remains an important health problem in South Africa (SA) with favourable outcomes in most, apart from those with crescentic glomerulonephritis who progressed to kidney failure.
(© 2024. The Author(s).)
Databáze: MEDLINE
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