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Pediatric post-streptococcal glomerulonephritis: Clinical and laboratory data.
Demircioglu Kilic, Beltinge; Akbalik Kara, Mehtap; Buyukcelik, Mithat; Balat, Ayse.
Afiliación
  • Demircioglu Kilic B; Department of Pediatric Nephrology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
  • Akbalik Kara M; Department of Pediatric Nephrology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
  • Buyukcelik M; Department of Pediatric Nephrology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
  • Balat A; Department of Pediatric Nephrology, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey.
Pediatr Int ; 60(7): 645-650, 2018 Jul.
Article en En | MEDLINE | ID: mdl-29729114
ABSTRACT

BACKGROUND:

Acute post-streptococcal glomerulonephritis (APSGN) is the most common post-infectious glomerulonephritis in childhood. The aim of this study was therefore to identify the possible risk factor(s) responsible for decreased glomerular filtration rate (GFR) in APSGN.

METHODS:

The data of patients followed up with a diagnosis of APSGN in the Pediatric Nephrology Clinic of Gaziantep University Hospital between October 2014 and October 2016 were retrospectively evaluated.

RESULTS:

The total number of subjects was 75 (male/female, 42/33) with a mean age of 8.20 ± 3.25 years. The most common presentations were edema (86.7%), macroscopic hematuria (82.7%) and hypertension (73.3%, n = 55). On laboratory examination, 28 children (37.3%) had hypoalbuminemia, 58 (77.3%) had proteinuria, 20 (26.7%) had increased C-reactive protein (CRP), while 74 (98.7%) and 12 (16%) had decreased complement (C)3 and C4, respectively. The number of children with GFR <90 mL/min/1.73 m2 was 22 (29.3%). The risk of decreased GFR was significantly higher in patients with increased CRP (P = 0.001; OR, 3.58), hypoalbuminemia (P = 0.006; OR, 4.83), and decreased C4 (P = 0.010; OR, 11.53). Additionally, white blood cell (WBC) count, neutrophil count, and neutrophil/lymphocyte ratio (NLR) were significantly higher (P = 0.02, P = 0.006, P = 0.004, respectively) in patients with low GFR.

CONCLUSIONS:

Although the prognosis of APSGN in children is good, severe systemic complications and renal failure may develop during the follow-up period. Decreased C4, presence of hypoalbuminemia, and increased inflammatory markers (WBC, CRP, neutrophil count and NLR) might be possible risk factors for severity of renal involvement. Decreased C4, in particular, may be a risk factor for decreased GFR in those children.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estreptocócicas / Glomerulonefritis Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Pediatr Int Asunto de la revista: PEDIATRIA Año: 2018 Tipo del documento: Article País de afiliación: Turquía

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estreptocócicas / Glomerulonefritis Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Pediatr Int Asunto de la revista: PEDIATRIA Año: 2018 Tipo del documento: Article País de afiliación: Turquía
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