The Epidemiology, Presentation, and Outcome of Acute Post-infectious Glomerulonephritis in North East India: A Single Centre Experience Post-infectious Glomerulonephritis in North East India
Journal of Pediatric Nephrology,
Vol. 10 No. 4 (2022),
15 March 2023
Background and Aim: Acute post-infectious glomerulonephritis (PIGN) can occur due to
various etiologies. Among these, post-streptococcal glomerulonephritis is the common cause.
Though the burden has drastically decreased over the years in developed nations, it remains a
reason for concern in developing countries. This study aimed to document the burden, clinical
presentation, etiology, and outcome of PIGN referred to a tertiary care center in a developing
Methods: This retrospective study was conducted in a tertiary care teaching hospital in
northeast India. All cases diagnosed with acute PIGN were included in the study. Cases
with an alternate diagnosis and cases with incomplete records were excluded from the study.
Data on relevant clinical, demographic, and laboratory variables were extracted from the
case records and discharge summary. Simple descriptive statistics, such as frequency and
proportion were used.
Results: A total of 202 cases of PIGN were included in the study. The Mean±SD annual
admission rate was 22.4±6.1 per year. The Mean±SD age at presentation was 10.0±3.9 years
and the male to female ratio was 1.2 to 1. The most common clinical features at the time of
presentation were hypertension in 183 patients (90.59%), edema in 168 (83.16%), history of
oliguria in 146(72.27%), and hematuria in 168 patients (83.2%). Proteinuria was present in 95
cases (47.03%). Either clinical or serological evidence of preceding streptococcal infection
was observed in 160 children (83.2 %). Two cases had scrub typhus and one case had hepatitis
B seropositivity. Hypertensive encephalopathy and left ventricular failure were observed in
20(9.90%) and 44 children (21.78%), respectively. Admission to the pediatric intensive care
unit was required in 28.21%. No mortality was observed.
Conclusion: PIGN constitutes a significant burden in this part of India. The incidence of
complications was high but the outcome was good with adequate acute care.
- Post-infectious Glomerulonephritis (PSGN)
- Hypertensive encephalopathy
- Streptococcal infection
How to Cite
Bagga A, RN Srivastava. Acute and rapidly progressive
glomerulonephritis. In Srivastava RN, Bagga A. (eds). In:
Pediatric Nephrology. 5th edition. New Delhi: Jaypee; 2011.
Pan CG, Avner ED. Acute poststreptococcal glomerulonephritis.
In: Kliegman RM, Stanton B, St. Geme J, Schor N,
Behrman RE, (eds). Nelson’s textbook of pediatrics. Philadelphia:
Elsevier Saunders; 2014. p. 2498.
Kasahara T, Hayakawa H, Okubo S, Okugawa T, Kabuki
N, Tomizawa S, et al. Prognosis of acute Poststreptococcal
Glomerulonephritis (APSGN) is excellent in children,
when adequately diagnosed. Pediatr Int. 2001;43 (4):364-7.
Sepahi MA, Shajari A, Shakiba M, Shooshtary FK, Salimi
MH. Acute glomerulonephritis: a 7 years follow up of children
in center of Iran. Acta Med Iran. 2011:375-8. [Link]
Rodriguez-Iturbe B, Musser JM. The current state of poststreptococcal
glomerulonephritis. J Am Soc Nephrol. 2008;
(10):1855-64. [DOI:10.1681/ASN.2008010092] [PMID]
Chaturvedi S, Boyd R, Krause V. Acute post-streptococcal
glomerulonephritis in the Northern Territory of Australia:
A review of data from 2009 to 2016 and comparison
with the literature. Am J Trop Med Hyg. 2018; 99(6):1643-8.
[DOI:10.4269/ajtmh.18-0093] [PMID] [PMCID]
Barman H, Sangla L, Ksoo R, Rapthap K. Pattern of pediatric
kidney diseases in a tertiary care center in Northeast India:
Autumn 2022. Volume 10. Number 4
a 5-year retrospective analysis. J Ped Nephrol. 2018; 6(2):1-5.
Flynn TJ, Kaelber DC, Baker-Smith CM, Blowey D, Carroll
AE, Deniels SR et al. Clinical practice guideline for screening
and management of high blood pressure in children and
adolescents. Pediatrics. 2017; 140(3):e20171904. [DOI:10.1542/
Viteri B, Reid-Adam J. Hematuria and proteinuria in children.
Pediatr Rev. 2018; 39(12):573-87. [DOI:10.1542/pir.2017-
Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C,
Warnock DG, et al. Acute kidney injury network: report of
an initiative to improve outcomes in acute kidney injury. Crit
Care. 2007; 11:R31. [DOI:10.1186/cc5713] [PMID] [PMCID]
Gunasekaran K, Krishnamurthy S, Mahadevan S, Harish
BN, Kumar AP. Clinical characteristics and outcome of postinfectious
glomerulonephritis in Children in Southern India:
A prospective study. Indian J Pediatr. 2015; 82(10):896-903.
Bhalla K, Gupta A, nanda S, Mehra S. Epidemiology and
clinical outcoms of acute glomerulonephritis in a teaching
hospital in north India. J Family Med Primary care. 2019;
:934-7 [DOI:10.4103/jfmpc.jfmpc_57_19] [PMID] [PMCID]
Carapetis JR, Steer AC, Mulholland EK, Weber M. The
global burden of group A streptococcal diseases. Lancet Infect
Dis. 2005; 5(11):685-694. [DOI:10.1016/S1473-3099(05)70267-
Ilyas M, Tolaymat A. Changing epidemiology of acute
post-streptococcal glomerulonephritis in Northeast Florida:
a comparative study. Pediatr Nephrol. 2008; 23(7):1101-6.
Kanjanabuch T, Kittikowit W, Eiam-Ong S. An update on
acute postinfectious glomerulonephritis worldwide. Nat Rev
Nephrol. 2009; 5(5):259-269. [DOI:10.1038/nrneph.2009.44]
Berríos X, Lagomarsino E, Solar E, Sandoval G, Guzmán
B, Riedel I. Post-streptococcal acute glomerulonephritis
in Chile--20 years of experience. Pediatr Nephrol. 2004;
(3):306-12. [DOI:10.1007/s00467-003-1340-9] [PMID]
Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Poststreptococcal
acute glomerulonephritis in children: clinical
features and pathogenesis. Pediatr Nephrol. 2011; 26(2):165-
Rajajee S. Post-streptococcal acute glomerulonephritis: a
clinical, bacteriological and serological study. Indian J Pediatr.
; 57(6):775-80. [DOI:10.1007/BF02722275] [PMID]
Sarkissian A, Papazian M, Azatian G, Arikiants N, Babloyan
A, Leumann E. An epidemic of acute postinfectious glomerulonephritis
in Armenia. Arch Dis Child. 1997; 77:342-4.
[DOI:10.1136/adc.77.4.342] [PMID] [PMCID]
Blumberg RW, Feldman DB. Observations on acute glomerulonephritis
associated with impetigo. J Pediatr. 1962;
:677-85. [DOI:10.1016/S0022-3476(62)80093-6] [PMID]
Fujinaga S, Ohtomo Y, Umino D, Mochizuki H, Takemoto
M, Shimizu T, et al. Pulmonary edema in a boy with
biopsy-proven poststreptococcal glomerulonephritis without
urinary abnormalities. Pediatr Nephrol. 2007; 22(1):154-55.
Rodríguez-Iturbe B, Najafian B, Silva A, Alpers CE. Acute
Postinfectious Glomerulonephritis in Children. In: Avner ED,
Harmon WE., Niaudet P, Yoshikawa N, Emma F, Goldstein
S (eds). Pediatric nephrology.7th Ed. Springer-Verlag Berlin
Heidelberg, 2016 p 960-975.
- Abstract Viewed: 135 times
- pdf Downloaded: 135 times