Clinicopathological and laboratory profile of infection-related glomerulonephritis in children. A prospective observational study.

Dr. Tirumani  Himabindu; Dr Archana  Challa; Dr. Ravula Chaitanya  Jyothi; Dr Ponugoti  Swetha

doi:10.51168/sjhrafrica.v6i12.2362

Authors

Dr. Tirumani Himabindu Associate Professor, Department of Pediatrics, Government Medical College, Suryapet, Telangana
Dr Archana Challa Associate Professor, Department of Pediatrics, Government Medical College, Nalgonda, Telangana
Dr. Ravula Chaitanya Jyothi Associate Professor, Department of Pediatrics, Government Medical College, Gadwal, Telangana
Dr Ponugoti Swetha Senior Resident Department of Pediatrics Government Medical College, Maheshwaram,Telangana

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2362

Keywords:

infection-related, glomerulonephritis, acute, nephritic, syndrome, children, complement, antistreptolysin O, renal, biopsy, outcomes

Abstract

Background

Infection-related glomerulonephritis (IRGN) remains an important cause of acute nephritic syndrome in children and continues to contribute to admissions for hypertension, edema, and renal dysfunction in many low- and middle-income settings.

Objectives: To describe the clinicopathological and laboratory profile of pediatric IRGN and to document early outcomes over six weeks.

Methods

A prospective observational study was conducted in a tertiary pediatric unit from August 2022 to February 2024. Children aged 1 month to 18 years presenting with acute nephritic features suggestive of IRGN were enrolled. Urinalysis, spot urine protein–creatinine ratio, renal function tests, complement (C3/C4), and antistreptolysin O (ASO) titres were obtained, and renal biopsy was performed when clinically indicated. Participants were followed for six weeks.

Results

A total of 158 children were included (mean age 7.87 ± 3.50 years). Antecedent infection was documented in 79.1%. Hematuria occurred in 89.9%, oliguria in 70.3%, and hypertension in 55.1%. Low complement levels were observed in 58.2% and ASO titres were positive in 62.0%. Renal biopsy was required in 12.0% and commonly showed proliferative patterns. At six weeks, complete recovery occurred in 67.1%; persistent hematuria, persistent proteinuria, and persistent hypertension were noted in 17.7%, 8.2%, and 7.0%, respectively.

Conclusion

Pediatric IRGN showed a predominantly nephritic presentation with frequent complement activation and generally favorable short-term outcomes. Early recognition of severe features and structured follow-up help detect complications and residual abnormalities.

Recommendations

Standardize early testing for proteinuria and complement status, and prioritize rapid blood pressure control and fluid management. Arrange follow-up visits to confirm resolution of hematuria, proteinuria, and hypertension.

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