Razi Journal of Medical Sciences

    Background & Aim: Epidemic acute post streptococcal glomerulonephritis(APSGN) usually shows a good prognosis in children, but some degrees of renal damage have been reported in sporadic forms. The aim of the present study is to evaluate the correlation between the severity of initial manifestations of APSGN and its prognosis in children. Patients & Method: The medical records of 66 children with APSGN who were admitted between 1989 and 2003 were reviewed. This retrospective descriptive study included criteria such as hematuria, recent streptococcal infection, transient decrease in C3, and short-term follow-up for at least six months. The severity of the disease on admission and the severity of renal damage on the last visit were scored. We used Students’ t-test, Wilcoxon rank test and Spearman to compare the means, scores and correlation respectively. P<0.05 was considered significant. Results: 66 children including 51 males and 15 females with the mean age of 8.94 years(±2.4) entered the study. The frequency of moderate to severe hypertension(P=0.03), hyperkalemia(P=0.01), azotemia(P=0.034) and proteinuria(P=0.01) was higher in children under ten. However, clinical, laboratory, and total scores on admission were not significantly different in the two groups. After 1.72 years of follow-up on average, 63% recovered, 6.34% showed some degrees of renal insufficiency, 7.57% had proteinuria, 28.78% presented abnormal urinalysis, and 4.54% remained hypertensive. There was a statistically significant correlation between the initial total laboratory scores and the final scores on the last follow-up(P=0.0001). Conclusion: Despite favorable course of APSGN, the persistence of some degrees of renal damage is not beyond expectations. Therefore, a longer period of follow-up, especially for patients with more severe initial clinical manifestations, is recommended.