Outcome of rapidly progressive glomerulonephritis post-streptococcal disease in children

• Published in: Néphrologie & thérapeutique Vol. 11; no. 6; pp. 487 - 491
• Main Authors: Jellouli, Manel, Maghraoui, Sondos, Abidi, Kamel, Hammi, Yosra, Goucha, Rim, Naija, Ouns, Zarrouk, Chokri, Gargah, Tahar
• Format: Journal Article
• Language: French
• Published: France 01-11-2015
• Subjects: Adolescent; Biopsy; Child; Child, Preschool; Cyclophosphamide - therapeutic use; Disease Progression; Female; Glomerulonephritis - microbiology; Glomerulonephritis - pathology; Glomerulonephritis - therapy; Glucocorticoids - therapeutic use; Humans; Immunosuppressive Agents - therapeutic use; Infant; Kidney - pathology; Male; Prognosis; Renal Dialysis; Renal Insufficiency - etiology; Renal Insufficiency - therapy; Retrospective Studies; Streptococcal Infections - microbiology; Streptococcal Infections - pathology; Streptococcal Infections - therapy; Young Adult; Biopsie rénale; Infection streptococcique; Renal biopsy; Enfant; Postinfectious glomerulonephritis; Renal failure; Glomérulonéphrite aiguë; Children; Insuffisance rénale
• ISSN: 1872-9177
• DOI: 10.1016/j.nephro.2015.04.005

Rapidly progressive glomerulonephritis is a rare form of postinfectious glomerulonephritis. The aim of this study was to describe the outcome of our patients with severe post-streptococcal glomerulonephritis.
This retrospective study was conducted in the department of pediatrics in Charles-Nicolle Hospital during a period of 13 years (1997-2009).
Twenty-seven children were identified. The mean age was 8.7 years. All patients presented renal failure at presentation. The mean serum creatinine at presentation was 376.9 μmol/L. Six patients presented nephrotic syndrome. Twenty-six children had renal biopsies. Renal biopsies showed crescents in 24 cases. Eighteen children received pulse dose of corticosteroids (66.6%) and 6 children (22%) received pulse dose of corticosteroids and cyclophosphamide. Eleven patients required dialysis. At last follow-up, 22 patients (81.5%) had normal kidney function, 2 had renal dysfunction and 3 reached end stage renal disease. The only significant determinant for renal survival was the supportive dialysis (P=0.015).
Rapidly progressive glomerulonephritis is uncommon. There have been significant advancements in supportive, as well as specific therapy, but the outcome continues to be poor.