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Open Access 03-01-2024 | Glomerulonephritis | Original Article

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

Authors: Khadija Abugrain, Mignon I McCulloch, Rudzani Muloiwa, Valerie A Luyckx, Heloise Buys

Published in: Pediatric Nephrology | Issue 6/2024

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Abstract

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.

Graphical abstract

Appendix
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Metadata
Title
A 6-year review of acute post-streptococcal glomerulonephritis at a public children’s hospital in Cape Town, South Africa
Authors
Khadija Abugrain
Mignon I McCulloch
Rudzani Muloiwa
Valerie A Luyckx
Heloise Buys
Publication date
03-01-2024
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 6/2024
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-023-06247-8

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