Childhood acute glomerulonephritis in Ibadan Nigeria

Abstract

Background: Acute glomerulonephritis (AGN) is an important cause of mortality and morbidity in children in developing countries while its  incidence has declined in the developed world. This study was to document its present impact in our setting.
Aim: To evaluate the sociodemographic features and clinical outcomes in children hospitalized for AGN in the Paediatric Nephrology Unit of the University College Hospital, Ibadan.
Subjects and Methods: This was a descriptive analytical study of children aged 2 to 14 years admitted with AGN between 2007 and 2019. Their sociodemographic data, clinical features, complications and outcome were analysed.
Results: AGN accounted for 116 (8.9%) of new renal cases admitted over the period. Seventy-four (63.8%) were male, mean age (SD) was 8.2 (3.3) years and peak age incidence between 5 and 9 years. Average annual hospital incidence rose from 4-5 new cases to 8-9 new cases/annum with an upsurge to 17 cases in 2019. Highest yearly monthly incidence was between June and December. Forty -five out of 50 (90%) evaluated subjects were in the middle/ low socioeconomic classes. Stage 2 hypertension occurred in 30/50 (60%) with hypertensive crises in 24%. RPGN occurred in 6/50 (12%) of cases accounting for 5 of the 8 dialysed patients and 4 of the 5 deaths. The case fatality rate was 4.3%.
Conclusion: The study showed a progressive increase in the hospital incidence of AGN.RPGN was a major risk factor for death in children with AGN and therefore requires a high index of suspicion and an appropriate early intervention.

Key words: Childhood, Acute Glomerulonephritis (AGN), Postinfectious AGN, Rapidly progressive glomerulonephritis (RPGN), Hypertensive crises,  Outcome