Nephritic syndrome and acute kidney injury following poststreptococcal glomerulonephritis in pediatric patients: A case report
DOI:
https://doi.org/10.70347/svsthya.v1i1.14Keywords:
Acute kidney injury, nephritic syndrome, hematuria, dysmorphic erythrocyte, glomerulonephritisAbstract
Acute kidney injury (AKI) is characterized by an abrupt decrease in glomerular filtration rate, manifesting as an increase in serum creatinine or oliguria. Nephritic syndrome, a manifestation of glomerulonephritis, presents with hematuria, hypertension, decreased urine output, and edema. This case report discusses an 11-year-old Asian boy who presented with decreased urination, shortness of breath, hypertension, and bilateral leg edema. Urinalysis revealed hematuria, proteinuria, and dysmorphic erythrocytes, while serum creatinine was elevated with a decreased estimated glomerular filtration rate (eGFR). The patient had a positive ASTO test, indicating poststreptococcal glomerulonephritis as the underlying cause of nephritic syndrome and AKI. Although most cases of poststreptococcal glomerulonephritis in children have a favorable outcome, some cases can develop into a serious, life-threatening condition that requires careful attention. This case highlights the importance of early detection and management of poststreptococcal glomerulonephritis to prevent progression to nephritic syndrome and AKI, especially in resource-limited settings. Modest examination modalities can facilitate early detection and faster patient management, particularly in developing countries, to reduce the risk of mortality associated with severe AKI in pediatric patients.
Downloads
References
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Kidney-disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl (2011) 2012;2:1–138. https://doi.org/10.1038/kisup.2012.1.
Mercado MG, Smith DK, Guard EL. Acute Kidney Injury: Diagnosis and Management. Am Fam Physician 2019;100:687–94. https://www.aafp.org/pubs/afp/issues/2019/1201/p687.html
Lamba P, Nam KH, Contractor J, KIm A. Nephritic Syndrome. Primary Care: Clinics in Office Practice 2020;47:615–29. https://doi.org/10.1016/j.pop.2020.08.003.
Wu C, Zhang Y, Nie S, Hong D, Zhu J, Chen Z, et al. Predicting in-hospital outcomes of patients with acute kidney injury. Nat Commun 2023;14. https://doi.org/10.1038/s41467-023-39474-6.
Fragasso T, Ricci Z, Goldstein SL. Pediatric Acute Kidney Injury. Contrib Nephrol 2018;193:113–26. https://doi.org/10.1159/000484968.
Demircioglu Kılıc B, Akbalık Kara M, Buyukcelik M, Balat A. Pediatric post-streptococcal glomerulonephritis: Clinical and laboratory data. Pediatrics International 2018;60:645–50. https://doi.org/10.1111/ped.13587.
Makris K, Spanou L. Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. 2016; 37: 85–98. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198510/
Yoon SY, Kim JS, Jeong KH, Kim SK. Acute Kidney Injury: Biomarker-Guided Diagnosis and Management. Medicina (Lithuania) 2022;58. https://doi.org/10.3390/medicina58030340.
Koza Y. Acute kidney injury: Current concepts and new insights. J Inj Violence Res 2014. https://doi.org/10.5249/jivr.v8i1.610.
Khanna R. Clinical Presentation & Management of Glomerular Diseases: Hematuria, Nephritic & Nephrotic Syndrome. Mo Med 2011; 108: 33–36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188440/
Demircioglu Kılıc B, Akbalık Kara M, Buyukcelik M, Balat A. Pediatric post-streptococcal glomerulonephritis: Clinical and laboratory data. Pediatrics International 2018;60:645–50. https://doi.org/10.1111/ped.13587.
Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: Clinical features and pathogenesis. Pediatric Nephrology 2011;26:165–80. https://doi.org/10.1007/s00467-010-1554-6.
Tasic V, Polenakovic M. Acute poststreptococcal glomerulonephritis following circumcision. Pediatr Nephrol 2000;15:274–5. https://doi.org/10.1007/s004670000451
Ahmed-Jushuf IH, Selby PL, Brownjohn A. Acute post-streptococcal glomeruionephritis following ear piercing. Postgrad Med J 1984;60:73–4. https://doi.org/ 10.1136/pgmj.60.699.73
Strife CF, McAdams AJ, McEnery PT, Bove KE, West CD. Hypocomplementemic and normocomplementemic acute nephritis in children: A comparison with respect to etiology, clinical manifestations, and glomerular morphology. J Pediatr 1974;84:29–38. https://doi.org/10.1016/S0022-3476(74)80549-4
Pesce F, Stea ED, Rossini M, Fiorentino M, Piancone F, Infante B, et al. Glomerulonephritis in AKI: From Pathogenesis to Therapeutic Intervention. Front Med (Lausanne) 2021;7. https://doi.org/10.3389/fmed.2020.582272.
Hebert LA, Parikh S, Prosek J, Nadasdy T, Rovin BH. Differential diagnosis of glomerular disease: A systematic and inclusive approach. Am J Nephrol 2013;38:253–6. https://doi.org/10.1159/000354390.
Fiorentino M, Bolignano D, Tesar V, Pisano A, Van Biesen W, D’Arrigo G, et al. Renal biopsy in 2015 - From epidemiology to evidence-based indications. Am J Nephrol 2016;43:1–19. https://doi.org/10.1159/000444026.
Rovin BH, Adler SG, Barratt J, Bridoux F, Burdge KA, Chan TM, et al. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int 2021;100:S1–276. https://doi.org/10.1016/j.kint.2021.05.021.
Satoskar AA, Parikh S V., Nadasdy T. Epidemiology, pathogenesis, treatment and outcomes of infection-associated glomerulonephritis. Nat Rev Nephrol 2020;16:32–50. https://doi.org/10.1038/s41581-019-0178-8.
Ong LT. Management and outcomes of acute post-streptococcal glomerulonephritis in children. World J Nephrol 2022;11:139–45. https://doi.org/10.5527/wjn.v11.i5.139.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Endah Indriastuti, Rahmah Yasinta Rangkuti, Alvin Hartanto Kurniawan
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This license enables reusers to copy and distribute the material in any medium or format in unadapted form only, for noncommercial purposes only, and only so long as attribution is given to the creator.
