Objective: To evaluate the clinical presentation, risk factors associated with acute poststreptococcal glomerulonephritis (APSGN) complications and outcome of pediatric APSGN.

Materials and Methods: Retrospective medical records were reviewed of all children diagnosed as APSGN at Queen Sirikit National Institute of Child Health (QSNICH) between January 1, 2006 and December 31, 2014.

Results: One hundred seventy-five cases were studied. The mean patient age was 8.6±2.7 years old, with a male to female ratio of 1.4:1. The upper respiratory tract antecedent infections were found in 53.7% of the cases, while antecedent skin infections had a prevalence of 30.9%. Clinical manifestations were edema in 99.4%, hypertension in 95.4%, acute kidney injury (AKI) in 48.6%, gross hematuria in 24.5%, rapidly progressive glomerulonephritis (RPGN) in 7.4%, and hypertensive encephalopathy in 5.7% of the cases. An elevated ASO titer and anti-DNase B were detected in 79.4% and 96.9% of the cases, respectively. Proteinuria was significant risk factors of AKI (adjusted OR 4.48, 95% CI 1.57 to 12.72, p=0.005), while obesity was significantly linked to hypertensive encephalopathy (OR 8.41, 95% CI 1.82 to 38.75, p=0.018). The result of the initial treatment was excellent. However, two cases experienced complete remission post-treatment for three years where one case developed proteinuria and the other presented with proteinuria and deterioration of kidney function.

Conclusion: Pediatric APSGN is more common in males and mostly occurs following sore throat. The most common clinical presentation is edema. Proteinuria is a significant risk factor for AKI, while obesity is significantly related to hypertensive encephalopathy. Short-term clinical outcome is excellent but long-term prognosis is uncertain.

Keywords: Acute poststreptococcal glomerulonephritis, APSGN, Acute kidney injury, AKI, Hypertensive encephalopathy

Received 10 Jul 2018 | Revised 18 Dec 2018 | Accepted 20 Dec 2018