ESPN 50th Annual Meeting

ESPN 2017


 
MAY DECREASED COMPLEMENT 4 BE A PREDICTİVE FACTOR OF DECREASED GLOMERULAR FILTRATION RATE IN CHILDREN WİTH ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS?
BELTINGE DEMIRCIOGLU KILIC 1 MEHTAP AKBALIK KARA 1 MITHAT BUYUKCELIK 1 AYSE BALAT 2

1- GAZIANTEP UNIVERSITY
2- ISTANBUL AYDIN UNIVERSITY
 
Introduction:

Acute poststreptococcal glomerulonephritis (APSGN) is the most common postinfectious glomerulonephritis in childhood. It was aimed to determine the possible risk factor(s), responsible for decreased glomerular filtration rate (GFR) in APSGN. 

Material and methods:

 The data of patients followed up with the diagnosis of APSGN in the Pediatric Nephrology Clinic of Gaziantep University Hospital between October 2014 and October 2016 were evaluated retrospectively. 

Results:

 Total number of subjects was 75 (E/K: 42/33) with the mean age of 8.20±3.25 years. Most common presentations were edema (86.7%), macroscopic hematuria (82.7%), proteinuria (77.3%), and hypertension (73.3%). In laboratory examination, 28 children (37.3%) had hypoalbuminemia, 20 (26.7%) with increased C reaktive protein (CRP), while 74 (98.7%) and 12 (16%) had decreased C3 and C4, respectively. The number of children with GFR value <90 ml/min/per 1.73/m2 was 22 (29.3%). The risk of decreased GFR was found significantly higher in patients with increased CRP (p:0.001, OR:3.58), hypoalbuminemia (p:0.006, OR:4.83), and decreased C4 (p:0.010, OR:11.53). Additionally,  leukocyte count, neutrophil count, and neutrophil lymphocyte ratio (NLR) were significantly higher (p:0.02, p:0.006, p:0.004, respectively) in patients with low GFR. 

Conclusions:

 Although the prognosis of APSGN in children is good, severe systemic complications and renal failure may develop in the follow-up period. We suggest that decreased C4, presence of hypoalbuminemia, increased inflammatory markers (CRP, number of leukocyte and NLR) might be possible risk factors for degree of renal involvement.