Outcomes of Rapidly Progressive Glomerulonephritisin children

Abstract

Background: Rapidly Progressive Glomerulonephritis (RPGN) is a form of glomerulonephritis characterized by an acute nephritic illness. The outcome is determined by the severity of renal failure at presentation, promptness of intervention, and the underlying renal pathology. Objectives: This study aimed to analyze the outcomes of pediatric rapidly progressive glomerulonephritis. Methods: This prospective observational study was conducted at the Department of Paediatric Nephrology, Bangladesh Shishu Hospital & Institute, from July 2021 to June 2023, with a sample size of 28. The study utilized a non-probability sampling technique, and data were analyzed using the SPSS version 20.0 program. Results: Patients with >50% crescentic involvement experienced gradual deterioration, requiring acute renal replacement therapy, while only 15% in the <50% crescentic group improved with conservative treatment. Overall mortality rates were 50% for IgA nephropathy, 33% for lupus nephritis, and 25% for Post Infectious Glomerulonephritis (PIGN). Improvement rates were 100% for Henoch-Schonlein purpura nephritis, 67% for lupus nephritis, and 50% for PIGN. No improvement occurred in >50% of crescentic cases, with a mortality rate of 62% and a 38% incidence of Chronic Kidney Disease (CKD). Conversely, <50% of crescentic cases showed a significant improvement rate of 65% (13/20) (p value=0.007). Conclusion: In this study higher risk of mortality found among patient with more than 50% glomerular crescents. Additionally, it indicates that Henoch Schönlein-purpura (HSP) nephritis is associated with the most favourable clinical outcome, while the mortality rate is highest (50%) in IgA nephropathy.

DS (Child) H J 2024; 40(2): 34-38