感染后肾小球肾炎(PIGN)的流行及相关并发症

B. Kalakheti, Brajesh Raj Chaudhary, H. Upadhyay
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摘要

感染后肾小球肾炎(PIGN)是儿童最常见的肾脏疾病,发病率高。患儿表现为急性肾综合征(血尿、高血压、水肿和少尿)。本研究的目的是确定三级医院儿科病房感染后肾小球肾炎患儿的患病率、临床特征、并发症和预后。方法:这是一项前瞻性观察研究,于2020年3月1日至2021年2月28日在尼泊尔奇旺的一家三级保健医院进行。满足急性肾病综合征4项特征中的2项的4 - 15岁儿童被纳入研究。出院后分别于4周和8周随访。数据输入是在社会科学版本20的统计软件包中完成的。结果63例急性肾病综合征患儿中,73%发生感染性后肾小球肾炎。最常见的病因是链球菌感染后肾小球肾炎(63%)。患儿平均年龄11.2(±3.2)岁。男女比例为1.5:1。最常见的表现是水肿(100%)。最常见的并发症是急性肾损伤(41.3%)。结论感染后肾小球肾炎是儿童急性肾病综合征最常见的病因。CCF、视网膜病变、脑病和肾功能不全等危及生命的并发症发生率高,需要密切监测和及时干预,以预防发病和死亡。
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Prevalence of Post Infectious Glomerulonephritis (PIGN) and Associated Complication
Introduction Post infectious glomerulonephritis (PIGN) is the most common renal disease in children causing significant morbidity. The affected children present with features of acute nephric syndrome (hematuria, hypertension, edema and oliguria. The objective of this study was to determine the prevalence, clinical characteristics, complications, and outcomes of children presenting with post infectious glomerulonephritis in paediatric ward of tertiary care hospital. Methods This was a prospective observational study conducted at a tertiary care hospital in Chitwan, Nepal from March 1st 2020 to February 28th 2021.   Children aged 4 – 15 years satisfying 2 out of 4 features of acute nephritic syndrome were included in the study. After discharge, patients were followed up at 4 weeks and 8 weeks. Data entry was done in statistical packages for the social science version 20. Results Among 63 children recruited with acute nephritic syndrome, 73% had Post infectious glomerulonephritis. The most common etiology of PIGN was Post streptococcal glomerulonephritis (63%). The mean age of children was 11.2 (±3.2) years. Males to females’ ratio was 1.5:1. The most common presenting feature was edema (100%). The most common complication was acute kidney injury (41.3%). Conclusion Post infectious glomerulonephritis was the most common cause of acute nephritic syndrome in children. High incidence of life-threatening complications like CCF, retinopathy, encephalopathy and renal insufficiency occur that require close monitoring and timely intervention to prevent morbidity and mortality.
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