Acute glomerulonephritis in children of the Niger Delta region of Nigeria

Abstract

A three-year retrospective study was conducted to determine the incidence, pattern of presentation and other clinical and biochemical features as well as outcome of treatment of patients admitted with acute glomerulonephritis at the Delta State University Teaching Hospital, Oghara and GN Children's Clinic, Warri. The case notes of all the children who presented with renal diseases from January 2010 to December 2012 were retrieved and those with acute glomerulonephritis were analyzed. A total of 20 patients (13 male and seven female) with acute glomerulonephritis were seen during the three-year period under review. Twelve patients (60%) were from the low socioeconomic class, six (30%) from the middle class and only two (10%) were from the high-income group. The presentation of the illness was most common between October and January. The age range of the patients was three to 13 years, with an average age of eight years. Seventeen (85%) of the patients were in the school-going age group (>5 years to 10 years). The most common symptom/sign noted was anemia in 90% of the patients, followed by oliguria/anuria and edema seen in 80% of the patients. Seventy percent of the patients had cola-colored urine, while 55% had hypertension. Some patients gave a history suggestive of previous streptococcal infection. More patients had sore throat (25%) than skin infection (10%). All the patients had proteinuria, while 90% had hematuria. The most common complication was acute kidney injury, seen in eight (40%) of the patients, followed by hypertensive encephalopathy, which occurred in three (15%) patients. Most patients (60%) were hospitalized for one to two weeks. The outcome of the management of these patients showed 14 (70%) of the patients recovered fully while three (15%) had persistent hematuria and two (10%) had persistent proteinuria. Ninety-five percent of the patients recovered from the acute illness and one patient (5%), a boy aged nine years old, died.

Post-Infectious Acute Glomerulonephritis in Child: Epidemiological, Clinical and Evolutionary Aspects in Gabriel Touré Teaching Hospital in Mali

“…Nigeria [19] and Iran [18] similar to our study. This reinforces the feeling that only visible and worrisome signs motivate medical management in low socio-economic setting.…”

“…All our patients were deprived from low socio-economic ranking. McGilUgwu also found (60%) of such patients in Nigeria [19]. Mola We found no causal infection in 30% of the patients.…”

“…We found hematuria in 69% of the patients versus 100% in a study in Niger [19]. High blood pressure was found in one third of the patients, 39% in the cohort of Bah O [17], over half of the patients in Nigeria [19] and in 82.4% patients in Israel [7]. Surprisingly, Sepahi MA found no cases of hematuria in Iran [18].…”

“…The presence of hematuria with urines "porto", "bouillon sale", "coca" can be the revealing sign of the disease [24]. We found hematuria in 69% of the patients versus 100% in a study in Niger [19]. High blood pressure was found in one third of the patients, 39% in the cohort of Bah O [17], over half of the patients in Nigeria [19] and in 82.4% patients in Israel [7].…”

“…In India, Gunasekaran K mainly found pyo-dermitis in 80.6% and few cases of varicella and measles [22]. In Nigeria, McGilUgwu GI [19] suspected streptococcal infection in 35%. VanDeVoorde RG [20], assumed that proper management of infections has decreased this form of APIGN worldwide in general.…”