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.