Glomerulonephritis in Children: Epidemiological, Clinical, Paraclinical and Therapeutic Profile

Abstract

Background: Glomerulonephritis (GN) is a rare kidney disease that causes significant morbidity and mortality. They are frequently difficult to treat, and in some cases, no treatment is available, and they can progress to chronic kidney disease (CKD) and end stage renal disease (ESKD). Kidney biopsy is the preferred diagnostic method because it helps determine the precise specific diagnosis, assesses the level of disease activity and severity, and thus aids in proper therapy and prognosis prediction. Methods: Retrospective review of 40 children under the age of 15 with GN diagnosed between 2019 and 2022. Nephrotic syndrome, sub-nephrotic proteinuria, nephrotic syndrome (NS) with acute kidney injury (AKI), subnephrotic proteinuria plus AKI, isolated hematuria, and unexplained renal impairment were the six clinical syndromes for which a kidney biopsy was performed in 25 patients. Hospital admission records, progression notes, and outpatient follow up were used to collect data. Results: Acute glomerulonephritis (AGN) with nephritic syndrome (NS) affected 53% of the patients. Patients with AGN-NS were more likely to develop hypertension (48.0% vs. 15.7%) and acute renal damage (32% vs. 10%). 48% of the patients had Acute Postinfectious Glomerulonephritis. 5% of the patients had membranoproliferative glomerulonephritis. 2.5% of patients with ANCA-negative rapidly progressive glomerulonephritis had extramembranous glomerulonephritis, and 2.5% had extracapillary glomerulonephritis. The kidneys of 24 people were biopsied. The most common reason for a kidney biopsy was rapidly progressing glomerulonephritis. Conclusion: Acute postinfectious glomerulonephritis has been the most common glomerulonephritis in our study over the last three years in our Marrakech department. It manifested as a rapidly progressive glomerulonephritis in twelve of the cases.