Hypocomplementemia (C3) as an Independent Predictor for Children with Acute Post-streptococcal Glomerulonephritis: A Long-Term Observation

Han, Kyoung Hee, Lee, Keum Hwa, Park, Se Jin, Yu, Rita, Kim, Seong Heon, Lee, I Re, Han, Song Yi, Kim, Hyon Suk, Kronbichler, Andreas, Li, Han, Koyanagi, Ai, Jacob, Louis, Shin, Jae Il, Kim, Ji Hong and Smith, Lee (2021) Hypocomplementemia (C3) as an Independent Predictor for Children with Acute Post-streptococcal Glomerulonephritis: A Long-Term Observation. European Review for Medical and Pharmacological Sciences, 25 (18). pp. 5674-5683. ISSN 2284-0729

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Abstract

OBJECTIVE: The aim of this study was to examine the altering patterns in clinical characteristics and severity of acute post-streptococcal glomerulonephritis (APSGN) in children. PATIENTS AND METHODS: We analyzed the medical records of 119 children who were diagnosed with APSGN from 1987 to 2018, retrospectively. The patients were divided into two groups: Group I (n=72, before 1998) and Group II (n=47, after 1998). Clinical, radiologic, and laboratory findings were compared between the two groups. RESULTS: The clinical manifestations, including vomiting (20.8% vs. 4.3%, p=0.014), oliguria (40.3% vs. 19.1%, p=0.016), and generalized edema (86.1% vs. 63.8%, p=0.005), were statistically less frequent since 1998. Pulmonary edema on chest X-ray (22.7% vs. 4.4%, p=0.014) was less frequent in Group II than in Group I. The level of BUN (23.3±19.3 vs. 18.8±11.2, p=0.009) was lower in Group II than in Group I, while that of creatinine was not significantly different between the two groups. C3 level was an independent factor for predicting the development of edema (odds ratio [OR]: 1.034, 95% CI: 1.010-1.060, p=0.006) and acute nephritic symptoms (≥2) (OR: 0.974, 95% CI: 0.952-0996, p=0.020). It was also negatively correlated with an increasing number of acute nephritic symptoms, including oliguria and edema, in patients with APSGN (R=−0.182, p=0.048). CONCLUSIONS: This study demonstrated that APSGN had favorable clinical manifestations and severity over the past 30 years. The monitoring of C3 levels can be used to assess the disease severity and risk of complications, including edema and oliguria, which are decreasing in South Korean children.

Item Type:	Journal Article
Keywords:	streptococcal infection, acute glomerulonephritis, complement C3, edema
Faculty:	Faculty of Science & Engineering
SWORD Depositor:	Symplectic User
Depositing User:	Symplectic User
Date Deposited:	18 Jan 2021 10:41
Last Modified:	20 Jan 2022 15:21
URI:	https://arro.anglia.ac.uk/id/eprint/706194

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