Asian Journal of Medicine and Health

Background: Acute Post-Streptococcal Glomerulonephritis (APSGN) is a common cause of acute glomerulonephritis in children, characterized by hematuria, edema, hypertension, and oliguria following a recent Group A β-hemolytic streptococcal infection. Although the majority of patients recover uneventfully, some present with atypical or severe manifestations such as acute kidney injury (AKI), hypertensive encephalopathy, or congestive cardiac failure, increasing morbidity and hospitalization.

Objective: To describe the clinical features and laboratory parameters of APSGN in children admitted to a tertiary care hospital and determine the complications of acute kidney injury.

Methods: This cross-sectional analytical study was conducted in the Department of Pediatric Nephrology, Bangladesh Shishu Hospital and Institute, Dhaka, from September 2019 to August 2020. Fifty children aged 3–18 years with APSGN were enrolled based on clinical and laboratory criteria.  Data were analyzed using SPSS version 22.0, and p<0.05 was considered statistically significant.

Results: Fifty children with APSGN were studied; 37 (74%) were male and 13 (26%) female. A preceding sore throat was reported in 54% and pyoderma in 42%. Facial edema was the most frequent feature (98%), followed by vomiting (50%), abdominal pain (50%), dyspnea (36%), headache (32%), and convulsions (20%). Hypertension was present in 86% of cases, with 70% classified as stage II. Hematuria and tachycardia were each observed in 78%, while proteinuria and oliguria occurred in 68%. Mean ASO titer was 712 ± 707 IU/mL, and complement C3 was reduced (0.26 ± 0.21 g/L). The mean serum creatinine and urea levels were 16.9 ± 27.5 mg/dL and 13.5 ± 14.3 mmol/L, respectively. Hypoalbuminemia (mean = 27.98 ± 5.18 g/L) and mild hypocalcemia were also noted. Urinalysis showed microscopic hematuria and proteinuria in most patients. Among complications, urinary tract infection was most common (30%), followed by acute kidney injury (24%), hypertensive encephalopathy (20%), and nephrotic syndrome (18%). Septicemia, metabolic acidosis, and congestive heart failure were each observed in 14% of cases.

Conclusion: Most patients were from rural, illiterate, low-socioeconomic backgrounds, with skin infection being the leading precipitating cause of acute glomerulonephritis. Edema, oliguria, hematuria, and hypertension were the common presenting features. While the disease is often self-limiting, a significant number developed serious complications, especially in resource-limited settings. Early diagnosis, close monitoring, timely management, and strengthened prevention of streptococcal infections are crucial to reducing morbidity and disease burden.