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Journal of the Korean Society of Pediatric Nephrology 2005;9(2): 137-142.
소아 연구균 감염 후 급성 사구체 신염의 예후
신윤혜, 이지연, 배기수
1아주대학교 의과대학 소아과학교실
2아주대학교 의과대학 소아과학교실
3아주대학교 의과대학 소아과학교실
Prognosis of Acute Poststreptococcal Glomerulonephritis (APSGN) in Children
Yun-Hye Shin, Ji-Yeon Lee, Ki-Soo Pai
1Department of Pediatrics, Ajou University School of Medicine
2Department of Pediatrics, Ajou University School of Medicine
3Department of Pediatrics, Ajou University School of Medicine
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Purpose : Acute poststreptococcal glomerulonephritis(APSGN) follows infection of group A$beta$-hemolytic streptococci. The prognosis of APSGN has been reported as favorable. However, several studies have reported that some patients progress to chronic renal failure. In an attempt to clarify this, we analyzed the clinical course of patients with APSGN.
Methods : Between January 2000 and December 2004, a total of 48 children who were diagnosed with APSGN according to the presence of hematuria, transient hypocomplementemia and evidence of group A $beta$-hemolytic streptococcal infection were evaluated.
Results : Six(12.5$%$) patients showed elevation of serum creatinine level but there was no patient with Persistent renal dysfunction. Blood pressure was controlled with ease in all patients and there was no case of persistent hypertension. Renal biopsy was done in 5 patients who showed heavy proteinuria or renal insufficiency and the outcomes showed findings consistent with ordinary APSGN except one with findings of rapidly progressive glomerulonephritis(RPGN). Serum complement levels normalized within 8 weeks(92.9$%$). Hematuria disappeared within 6 months(79$%$) and proteinuria within 6 months(100$%$) from the disease onset.
Conclusion : Prolonged renal dysfunction or heavy proteinuria found in five patients(10.4$%$) led to renal biopsy. All these problems resolved within 6 months. Our data support that the prognosis of childhood APSGN is favorable without any serious sequoia. (J Korean Soc Pediatr Nephrol 2005;9:137-142)
Key words: Acute poststreptococcal glomerulonephritis | Transient hypocomplementemia | Proteinuria | RPGN
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