The Comparative Study of Clinical Manifestations in Acute Poststreptococcal Glomerulonephritis with Gross Hematuria or Microscopic Hematuria

Park, Su-Hwa; Chung, Eun-Soo; Sim, Chang-Eun; Kim, Kee-Hyuck; Lee, Chong-Guk

J Korean Soc Pediatr Nephrol > Volume 8(2); 2004 > Article

J Korean Soc Pediatr Nephrol 2004;8(2): 159-165.

연쇄상구균 감염후 급성 사구체신염에서 육안적 혈뇨와 현미경적 혈뇨에 따른 임상양상의 비교

박수화, 정은수, 심창은, 김기혁, 이종국

¹성균관대학교 의과대학 삼성서울병원 소아과
²성균관대학교 의과대학 삼성서울병원 소아과
³인제대학교 의과대학 일산백병원 소아과
⁴국민건강보험공단 일산병원 소아과
⁵인제대학교 의과대학 일산백병원 소아과

The Comparative Study of Clinical Manifestations in Acute Poststreptococcal Glomerulonephritis with Gross Hematuria or Microscopic Hematuria

Su-Hwa Park, Eun-Soo Chung, Chang-Eun Sim, Kee-Hyuck Kim, Chong-Guk Lee

¹Department of Pediatrics, College of Medicine, Sungkyunkwan University, Samsung Medical Center
²Department of Pediatrics, College of Medicine, Sungkyunkwan University, Samsung Medical Center
³Department of Pediatrics, College of Medicine, Inje University, Ilsan Paik Hospital
⁴Department of Pediatrics, NHIC Ilsan Hospital
⁵Department of Pediatrics, College of Medicine, Inje University, Ilsan Paik Hospital

ABSTRACT

PURPOSE: This study aimed to compare the clinical outcome of acute poststreptocaccal glomerulonephritis (APSGN) between patients who had presented with gross hematuria and those with microscopic hematuria. METHODS: Thirty-nine patients with acute poststreptococcal glomerulonephritis, who were diagnosed from January 2000 to April 2003 were enrolled. RESULTS: The mean age was 8.85 years and the male to female ratio was 1.1:1. Seventeen patients presented with gross hematuria at diagnosis(group A) and twenty-two patients had microscopic hematuria only(group B). There were no significant differences between the two groups in the incidence of edema, fever or history of respiratory infection and oliguria. But hypertension was more frequent in group B. Laboratory data showed decreased C3 and C4 level in group B. Spot urine protein/creatinine ratio and 24hr urine protein showed higher levels in group A. CONCLUSION: Patients with gross hematuria at diagnosis had lower incidence of hypertension and a higher rate of nephrotic range of proteinuria than patients with microscopic hematuria. However, no difference in the duration of admission or complication rate was observed. All patients had clinical improvement during follow-up. We conclude that gross hematuria is not a significant prognostic factor for poststreptococcal glomerulonephritis.

Key words: Glomerulonephritis | Hematuria | Streptococcal infections