Childhood acute post-infectious glomerulonephritis: a study of clinical profile and outcomes at the University of Abuja Teaching Hospital, Abuja, Nigeria, 2016 to 2021

Abstract

Background: Acute post-infectious glomerulonephritis (PIGN) is a common cause ofchildhood morbidity in developing countries, the burdenof which reflects low socio-economic conditions andpoor environmental and personal hygiene. In Nigeria,temporal and geographical variations exist for theepidemiology of PIGN but more information isneeded.
Materials and Methods: A retrospective review of socio-demographic factors and clinical outcomes ofchildhood PIGN at the University of Abuja TeachingHospital, Abuja, from January 2016 to December 2021.
Results: Out of 13,823 children, 506 were renal cases, and 55 were PIGN, with PIGN accounting for 10.9% of renal cases. Among the 50 PIGN studied, 32 were males (64%), with a male-to-female ratio of 1.7: 1 (p<0.009). The age range was 4 to 15 years, with a median age of 8 years, and a majority (50%) were of the school-age group (5-10 years) (p<0.0031). Affected children were mostly (38, 76%) from low socio-economic households (p=Â 0.0001). The typical clinical features were passage of cokecoloured urine (100%), peripheral oedema (90%) and hypertension (90%); while the commonest laboratory features were haematuria (100%), proteinuria (94%) and decreased complement C3/normal C4 levels (30 of 30 subjects) Acute complications comprised acute kidney injury (56%), congestive heart failure (16%) and urinary tract infections (14%). A majority (92%) were discharged with a low case fatality rate of 4% (2 deaths).
Conclusion: PIGN is common in our setting but with a good clinical outcome. The need to improve the citizenry’s socio-economic status and personal and environmental hygiene cannot be over-emphasized.