ACUTE GLOMERULONEPHRITIS IN A RESOURCE LIMITED SETTING-PREVALENCE AND CLINICAL MANIFESTATIONS

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ACUTE GLOMERULONEPHRITIS IN A RESOURCE LIMITED SETTING-PREVALENCE AND CLINICAL MANIFESTATIONS

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Co-author 1

Sandrica Young Peart sandricap@yahoo.com University of the West Indies, Mona Child & Adolescent Health Kingston Jamaica -

Co-author 2

Toni-ann Dunn dunntoniann@hotmail.co.uk University of the West Indies, Mona Child & Adolescent Health Kingston Jamaica *

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Introduction

Acute glomerulonephritis is characterized by immune mediated damage to the glomeruli. It necessitates timely diagnosis and treatment to prevent significant sequelae. There is a dearth of published studies regionally within the 20th century.

Methods

This is a retrospective, single centre descriptive study to review the prevalence, etiology and complications of children ages 29 days to < 12 years old admitted at tertiary pediatric hospital with AGN during the period January 1, 2014 to December 31, 2023. Ethical approval was obtained from the relevant ethical authorities. Data was collected by a data extraction sheet for those meeting the inclusion criteria and analysed using the Statistical Package for the Social Sciences software, version 18. P value < 0.05 was statistically significant.

Results

Eighty-two children were eligible for the study. There was a male preponderance (76%). The estimated prevalence of AGN was 0.08%. Ninety percent (90%) of AGN were due to PIGN (post infectious glomerulonephritis). 97% of PIGN were due to PSGN (post- streptococcal glomerulonephritis). The most common antecedent infection was respiratory tract infections (50%) and impetigo (43%). There were no significant associated risk factors. Fifty percent of PSGN were normo-complementemic. Eight-three (83%) of patients had acute complications; with the most common being hypertensive urgency/emergency (69%) p=0.041 and acute kidney injury 12%. Chronic hypertension was present in 6%. None of the patients developed CKD. Seventy percent (70%) defaulted follow up.

Conclusion

PSGN remains a significant cause of morbidity in resource limited settings, highlighting the need for generalized rapid strep antigen testing and greater need for follow up. Future studies are needed to examine the long-term renal outcomes of patients with AGN.

Kewords