Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational Study

Introduction: Acute poststreptococcal glomerulonephritis (APSGN) remains a significant public health concern, especially in pediatric populations. This decadelong observational study aims to provide a comprehensive exploration of pediatric APSGN, emphasizing on factors those influencing glomerular f...

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Main Authors: Doğukan Mustafa Keskin, Pınar Belviranlı Keskin, Mehmet Kocaoğlu, Alper Yıldırım, Oğuz Eğil
Format: Article
Language:English
Published: Galenos Publishing House 2024-04-01
Series:Güncel Pediatri
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Online Access:https://www.guncelpediatri.com/articles/factors-affecting-glomerular-filtration-rate-and-length-of-hospitalization-in-pediatric-acute-poststreptococcal-glomerulonephritis-a-decade-long-observational-study/doi/jcp.2024.55476
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author Doğukan Mustafa Keskin
Pınar Belviranlı Keskin
Mehmet Kocaoğlu
Alper Yıldırım
Oğuz Eğil
author_facet Doğukan Mustafa Keskin
Pınar Belviranlı Keskin
Mehmet Kocaoğlu
Alper Yıldırım
Oğuz Eğil
author_sort Doğukan Mustafa Keskin
collection DOAJ
description Introduction: Acute poststreptococcal glomerulonephritis (APSGN) remains a significant public health concern, especially in pediatric populations. This decadelong observational study aims to provide a comprehensive exploration of pediatric APSGN, emphasizing on factors those influencing glomerular filtration rate (GFR) and also contributing to prolonged hospitalization. Materials and Methods: The single-center, observational, retrospective study was conducted from January 2010 to December 2020 and included children aged 3-18 years diagnosed with APSGN. Diagnostic criteria included hematuria, decreased serum complement-3 levels, and evidence of recent streptococcal infection. Data extracted from medical records encompassed demographic details, clinical features, and a range of laboratory parameters. Results: Forty-four patients with APSGN were included (mean age: 8.65±3.31 years), 54.55% of whom were male. Hematuria was present in all cases (macroscopic hematuria in 77.27% of patients), edema in 63.64% of cases, and hypertension in 50.00% of cases. There was a negative correlation between inflammatory markers (C-reactive protein, neutrophil count, and neutrophil-to-lymphocyte ratio) and GFR (r: -0.511, r: -0.302, r: -0.380; p :< 0.05 respectively). Decreased GFR, albumin, and complement-3 levels (r: -0.361, r: -0.442, r: -0.315; p :< 0.05, respectively), and increased urine density and urinary protein excretion, correlated significantly with prolonged hospitalization r: 0.413, r: 0.362; p:< 0.05, respectively). Conclusion: Despite the generally favorable prognosis of pediatric APSGN, this study highlights the potential for severe complications. Elevated inflammatory markers signal severe renal involvement, while decreased GFR, albumin, and complement-3 levels, as well as increased urine density and protein excretion, lead to extended hospital stays. These findings may be used for anticipating patient outcomes and optimizing resource utilization in pediatric APSGN care.
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spelling doaj-art-cd43945dace44746b7f5c47ec991e37c2025-08-20T02:50:20ZengGalenos Publishing HouseGüncel Pediatri1304-90541308-63082024-04-012211810.4274/jcp.2024.55476Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational StudyDoğukan Mustafa Keskin0https://orcid.org/0000-0002-5706-5599Pınar Belviranlı Keskin1https://orcid.org/0000-0003-3921-384XMehmet Kocaoğlu2https://orcid.org/0000-0001-9402-9258Alper Yıldırım3https://orcid.org/0000-0001-8502-5298Oğuz Eğil4https://orcid.org/0000-0001-5112-5733Dr. Ali Kemal Belviranli Obstetrics and Gynecology Hospital, Clinic of Pediatrics, Konya, TurkeyNecmettin Erbakan University Meram Faculty of Medicine, Department of Infectious Disease, Konya, TurkeyDr. Ali Kemal Belviranli Obstetrics and Gynecology Hospital, Clinic of Pediatrics, Konya, TurkeyDr. Ali Kemal Belviranli Obstetrics and Gynecology Hospital, Clinic of Pediatrics, Konya, TurkeyCengiz Gökçek Obstetrics and Gynecology Hospital, Clinic of Pediatrics, Gaziantep, TurkeyIntroduction: Acute poststreptococcal glomerulonephritis (APSGN) remains a significant public health concern, especially in pediatric populations. This decadelong observational study aims to provide a comprehensive exploration of pediatric APSGN, emphasizing on factors those influencing glomerular filtration rate (GFR) and also contributing to prolonged hospitalization. Materials and Methods: The single-center, observational, retrospective study was conducted from January 2010 to December 2020 and included children aged 3-18 years diagnosed with APSGN. Diagnostic criteria included hematuria, decreased serum complement-3 levels, and evidence of recent streptococcal infection. Data extracted from medical records encompassed demographic details, clinical features, and a range of laboratory parameters. Results: Forty-four patients with APSGN were included (mean age: 8.65±3.31 years), 54.55% of whom were male. Hematuria was present in all cases (macroscopic hematuria in 77.27% of patients), edema in 63.64% of cases, and hypertension in 50.00% of cases. There was a negative correlation between inflammatory markers (C-reactive protein, neutrophil count, and neutrophil-to-lymphocyte ratio) and GFR (r: -0.511, r: -0.302, r: -0.380; p :< 0.05 respectively). Decreased GFR, albumin, and complement-3 levels (r: -0.361, r: -0.442, r: -0.315; p :< 0.05, respectively), and increased urine density and urinary protein excretion, correlated significantly with prolonged hospitalization r: 0.413, r: 0.362; p:< 0.05, respectively). Conclusion: Despite the generally favorable prognosis of pediatric APSGN, this study highlights the potential for severe complications. Elevated inflammatory markers signal severe renal involvement, while decreased GFR, albumin, and complement-3 levels, as well as increased urine density and protein excretion, lead to extended hospital stays. These findings may be used for anticipating patient outcomes and optimizing resource utilization in pediatric APSGN care.https://www.guncelpediatri.com/articles/factors-affecting-glomerular-filtration-rate-and-length-of-hospitalization-in-pediatric-acute-poststreptococcal-glomerulonephritis-a-decade-long-observational-study/doi/jcp.2024.55476acute post-streptococcal glomerulonephritisglomerular filtration ratehematurianephritic syndromepediatric nephrology
spellingShingle Doğukan Mustafa Keskin
Pınar Belviranlı Keskin
Mehmet Kocaoğlu
Alper Yıldırım
Oğuz Eğil
Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational Study
Güncel Pediatri
acute post-streptococcal glomerulonephritis
glomerular filtration rate
hematuria
nephritic syndrome
pediatric nephrology
title Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational Study
title_full Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational Study
title_fullStr Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational Study
title_full_unstemmed Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational Study
title_short Factors Affecting Glomerular Filtration Rate and Length of Hospitalization in Pediatric Acute Poststreptococcal Glomerulonephritis: A Decade-Long Observational Study
title_sort factors affecting glomerular filtration rate and length of hospitalization in pediatric acute poststreptococcal glomerulonephritis a decade long observational study
topic acute post-streptococcal glomerulonephritis
glomerular filtration rate
hematuria
nephritic syndrome
pediatric nephrology
url https://www.guncelpediatri.com/articles/factors-affecting-glomerular-filtration-rate-and-length-of-hospitalization-in-pediatric-acute-poststreptococcal-glomerulonephritis-a-decade-long-observational-study/doi/jcp.2024.55476
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