Erythrocyturia and proteinuria conversion in post-streptococcal acute glomerulonephritis

• Main Author: I Ketut Suarta
• Format: Article
• Language: English
• Published: Indonesian Pediatric Society Publishing House 2016-10-01
• Series: Paediatrica Indonesiana
• Subjects: Post-streptococcal acute glomerulonephritis; erythrocyturia; proteinuria
• Online Access: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/904
• ISSN: 0030-9311; 2338-476X

Background Acute glomerulonephritis (AGN) is a sudden onset of macroscopic hematuria and edema. The chronic post-strepto- coccal acute glomerulonephritis (PSAGN) can be predicted if mi- croscopic hematuria, proteinuria, and low serum complement C3 level are present for a period exceeding six months after initial onset of illness. It is prudent to follow the course of PSAGN until proteinuria normalizes and microhematuria disappears in urinalysis. Objective To acquire the time of erythrocyturia and proteinuria conversion in post-streptococcal acute glomerulonephritis (PSAGN) among children. Methods A retrospective cohort study on children with PSAGN was conducted in the Pediatric Outpatient Clinic and Ward at Sanglah Hospital, Denpasar, Bali from January 2001-December 2003. All subjects were recorded for clinical and laboratory signs, including initial symptoms, history of previous streptococcal infec- tions, blood pressure, complete blood count, serum albumin, ASTO titer, complement C3 level, BUN, and serum creatinin. Erythrocyt- uria and proteinuria follow-ups were done by recording urinalysis findings for a six-month period after initial onset. Results Thirty subjects 21 boys and 9 girls, mean age 8.7 (SD 2.5) years] with PSAGN were enrolled in the study, 16 had hematuria with edema. Twenty-one subjects had the history of upper respiratory tract infections and 9 with skin infections. Mean systolic blood pressure was 141.3 (SD 21.8) mmHg, mean diastolic blood pressure was 90.8 (SD 16.3) mmHg, mean ASTO titer was 1103.3 (SD 686.1) IU/ml, and mean complement C3 level was 42.2 (SD 15.5) mg/dl. Urinalysis monitoring showed 2/30, 9/30, 12/30, 22/30, 27/30 subjects had conversion he- maturia at the first, second, third, fourth, and fifth month, respectively. Median duration of erythrocyturia conversion was 4.0 months (95% CI: 3.53-4.47). There were 11/30, 18/30, 21/30, 23/30, 25/30, 26/30 sub- jects with proteinuria conversion at the first, second, third, fourth, fifth, and sixth month, respectively. Median duration of proteinuria conver- sion was 2.0 months (95% CI: 1.25-2.75). Conclusion Three out of 30 children remained with persistent hematuria and 4 of 30 remained with persistent proteinuria