Clinical characteristics of hospitalised children with acute post‐streptococcal glomerulonephritis in the Top End of Australia

Abstract

Aims Despite the declining incidence of acute post‐streptococcal glomerulonephritis (APSGN) in Australia, there is still a significant burden of disease amongst Aboriginal and Torres Strait Islander people in the Northern Territory. Childhood APSGN has been highlighted as a predictor of chronic kidney disease in this population. We aimed to describe clinical characteristics and outcomes of hospitalised children with APSGN in the Northern Territory. Methods Single‐centre, retrospective cohort study of children (<18 years) with APSGN admitted to a tertiary hospital in the Top End of the Northern Territory between January 2012 and December 2017. Cases were confirmed using the Centre for Disease Control case definition guidelines. Data were extracted from the case notes and electronic medical records. Results There were 96 cases of APSGN with median age of 7.1 years (interquartile range (IQR) 6.7–11.4). Majority were Aboriginal and Torres Strait Islander (90.6%) and from rural and remote areas (82.3%). Preceding skin infections were identified in 65.5% and sore throat in 27.1%. Severe complications included hypertensive emergencies (37.4%), acute kidney injury (43.8%) and nephrotic‐range proteinuria (57.7%). All children improved from their acute illness with supportive medical therapy; however, only 55 out of 96 (57.3%) children were followed up within 12 months of their acute illness. Conclusions APSGN disproportionately affects Aboriginal and Torres Strait Islander children and highlights the need for continued and improved public health response. There is room for significant improvement in the medium‐ and long‐term follow‐up of affected children.

Kidney transplantation access and outcomes for Aboriginal and Torres Strait Islander children and young adults, 1963–2020: an ANZDATA registry study

“…Australian transplant policy already advocates for paediatric priority allocation; however, this study identified persisting inequity, and this requires an urgency for additive priorities for Aboriginal and Torres Strait Islander children. These priorities include preventing the onset of chronic kidney disease after acute kidney injury, 38 preventing diabetic nephropathy following young onset diabetes, and when their kidney function reaches end‐stage, prioritising health care models which support their access to dialysis, transplant waitlisting, and achieving early transplantation (especially within five years) 39 . These recommendations support the National Indigenous Kidney Transplantation Taskforce position statement, which references improving young peoples’ kidney health and wellbeing through transplantation 39…”