Clinical Profile and Outcome of Acute Glomerulonephritis in a Tertiary Care Centre in the Eastern Nepal

Abstract

Introduction: Acute glomerulonephritis (AGN) generally presents as a constellation of findings that includes hematuria, edema, and often hypertension. The study aimed to determine the clinic-biochemical profile and outcome of acute glomerulonephritis in children at tertiary care centre in the Eastern Part of Nepal.

Methods: A prospective study was conducted on all the cases found to have acute glomerulonephritis, and sample size constituted all children between 1 month to 15 year, attending the Renal Special OPD and those hospitalized in pediatric department of BPKIHS from Feb. 2012 to Jan.2013 with acute glomerulonephritis.

Results: There were total of 94 cases of acute glomerulonephritis (AGN), which comprise 3.1% of annual pediatric admissions. 52.1% were female and male were 47.8%. Mean age of presentation was 9.2 yrs. ±3.1 SD. Aetiology of AGN was post infectious glomerulonephritis (PIGN) 84.0%, lupus nephritis 10.6%, mumps nephritis 3.1% and HSP nephritis 2.1%. ASO titer was raised in 34.0%. 47.8% had raised urea, 43.6% had raised creatinine level, >2+ proteinuria was present in 26.6% and pyuria in 34.0%. The common clinical findings at presentation were microscopic hematuria (95.7%), hypertension (86.2%), edema (85.1%), fever(63.8%), oliguria(22.3%), pain abdomen (21.3%) and others. History of sore throat and pyoderma was present in 25.5% and 19.1% respectively. Complications at presentation were hypertensive encephalopathy (9.5%), cardiac failure (9.5%) and acute kidney injury (6.3%). Of 94 cases, 92 cases (97.8%) improved and 2 cases (2.1%) expired due to acute kidney injury.

Conclusion: Acute glomerulonephritis is a significant renal problem in children and is one of the common causes of hospital admission. Early identification and comprehensive monitoring and management is required to prevent morbidity and mortality.