Post-streptococcal acute glomerulonephritis in children:Association between proteinuria levels and renal outcomes  

作　　者：Randula Ranawaka Kavinda Dayasiri Udara Sandakelum Dulani Nelson Manoji Gamage 

机构地区：[1]Department of Paediatrics,Faculty of Medicine,University of Colombo,Colombo 0094,Sri Lanka [2]University Paediatric Unit,Lady Ridgeway Hospital for Children,Colombo 0094,Western,Sri Lanka [3]Department of Paediatrics,Faculty of Medicine,University of Kelaniya,Ragama 0094,Sri Lanka [4]University Pediatric Unit,Lady Ridgeway Hospital for Children,Colombo 0094,Western,Sri Lanka [5]Nutrition Division,Ministry of Health,Colombo 0094,Sri Lanka

出　　处：《World Journal of Clinical Pediatrics》2025年第1期119-126,共8页世界临床儿科杂志（英文）

摘　　要：BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine cl

关 键 词：PROTEINURIA Post-streptococcal acute glomerulonephritis Renal outcome Renal biopsy Crescents Serum creatinine 

分 类 号：R726.8[医药卫生—儿科]