0A-S6-5

POSTINFECTIOUS ACUTE GLOMERULONEPHRITIS (AGN) AMONG FILIPINO CHILDREN 1998-2000

Alfiler CA

UP-PGH Medical Center, Manila, Philippines

 

Objective: To determine the current profile of postinfectious/poststrep-

tococcal AGN among Filipino children hospitalized between Jan 1, 1998    and Dec 31, 2000 in 3 accredited pediatric nephrology training centers.

Method: Retrospective study; chart review

Results: Of 199 admissions (66/yr), 163 charts were available for review. Mean age at onset was 3.03 yr and M:F ratio was 1.5:1 Poststreptococcal sorethroat, pyoderma or dental infection were proven or highly-presumed in 135 (82.8%). Edema, gross hematuria, hypertension and oliguria were the most common presenting complaints. Microhematuria and proteinuria were noted in all; creatininemia and hyperkalemia were documented in11% and 8% who were tested. ASO titer was high in 86% (119/138) and serum complement C3 was low in 88% (102/116). Of imaged cases, 51% showed evidence of renal parenchymal disease. AGN was uncomplicated in 89.6% of cases; congestive heart failure and hypertensive encephalopathy were the only complications noted. Supportive management was the rule; pharmacologic therapy consisted of penicillin, furosemide and a variety of hypotensives. No one was dialyzed or transplanted. 135 children (82.8%) followed up after a mean period of 3.9 mo were all clinically well with no active renal disease.

Conclusion: The profile of this group of AGN patients was similar to that observed among 208 admitted cases in an earlier Philippine multicenter survey done 15 yrs ago (1983-86). Both groups carried a very good prognosisregardless of the initial and subsequent clinicochemical behavior. A number of postinfectious/poststreptococcal AGN still needs hospital admission for better supportive and pharmacologic care.