Original Article

Pediatric Nephrology

, Volume 24, Issue 5, pp 1021-1026

Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children

  • William WongAffiliated withDepartment of Nephrology, Starship Children’s Hospital Email author 
  • , Maxwell Clarke MorrisAffiliated withDepartment of Nephrology, Starship Children’s Hospital
  • , Jonathan ZwiAffiliated withDepartment of Anatomic Pathology, LabPLus, Auckland City Hospital

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Abstract

Post-streptococcal glomerulonephritis (PSGN) is the commonest cause of severe acute glomerulonephritis in New Zealand children, with the majority (85%) of the patients being of either Pacific Island or Maori ethnicity. We have performed a retrospective study on 27 pediatric patients with acute PSGN. Of these patients, those with crescentic glomerulonephritis (n = 11) had a greater tendency (72.7%) for needing acute dialysis and were left with persistent urinary sediment abnormalities after a mean follow-up of 3.2 years (95% confidence interval 2.1–4.3). The efficacy of immunosuppression in the group with crescentic disease was uncertain. The severity of renal histopathological abnormalities as judged by the total biopsy score did not correlate with either presentation or eventual outcome. Severe childhood acute post-streptococcal glomerulonephritis, although uncommon, results in significant long-term renal morbidity, particularly among Maori and Pacific Island children.

Keywords

Acute glomerulonephritis Crescentic Infection Post-streptococcal Rapidly progressive children