Acute Post Streptococcal Glomerulonephritis among Children from Sokoto, North-Western Nigeria

Abstract

Aims: To determine the clinical and laboratory profile of children with acute post streptococcal glomerulonephritis (APSGN) admitted into Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, the outcome, and factors associated with in-hospital mortality. Study Design: A 5- year retrospective study. Place of Study: Emergency Paediatric Unit (EPU) and Paediatric Medical Ward (PMW) of the Department of Paediatrics, UDUTH Sokoto. Methodology: The records of children aged 4 to 14 years with the diagnosis of APSGN were reviewed. Relevant history, physical examination findings, laboratory and radiologic investigation findings were extracted from their case folders and recorded into a proforma sheet. Data was analyzed using SPSS version 23. (IBM SPSS Inc., USA). The level of statistical significance was set at 5%, which is p-value < 0.05. Results: Fifty-four (0.9%) of the 6128 children were managed for APSGN giving a prevalence of 10.8 APSGN cases per 1000 children. Forty-one folders were utilized for the study. There were 21(51.2%) females and 20(48.8%) males, with F:M ratio of 1.1:1. Mean age at presentation was 9.1± 3.1 years. Majority (92.6%) were ≥5 years and mainly 22(53.7%) of low socio-economic status. The main features were body swelling 40(97.6%), fever 25(61.0%), oliguria 24(58.5%), systemic hypertension 37(90.2%), proteinuria 41(100.0%), and haematuria 41(100.0%). Acute kidney injury was the commonest 25(61.0%) complication. Thirty (73.2%) cases were discharged, 5 (12.2%) died, 6(14.6%) left against medical advice. Low social status (0.03), requirement for dialysis (p=0.003), congestive cardiac failure (p=0.01), and pulmonary oedema (p=0.04) were significantly associated with in-hospital mortality. Requirement for dialysis (p=0.005) was the independent predictor of in-hospital mortality. At three months post discharge, 20(48.8%) of the 31 cases had achieved complete resolution of APSGN. Conclusion: APSGN is common in Sokoto and similar in pattern to other reports from Nigeria. The presence of complications at presentation increases the risk of in-hospital mortality.