RENAL DISEASE IN CHILDREN

Abstract

Incidence and Epidemiology A frequent kidney disease in childhood, is usually recognized if gross hematuria is present, but may not be recognized in the absence of this manifestation. In the presence of epidemics of this disease it has been discovered that nearly 20 times the number of recognized cases of the disease may exist in a community as otherwise unrecognized cases unless specially sought for. Acute hemorrhagic nephritis is often associated with infections caused by Group A, Type 12 Hemohytic streptococcus. The occurrence of acute nephritis following infection with one of the specific nephrogenic streptococci may account for the limited recurrence of instances of acute nephritis; owing to development of type-specific immunity. Current knowledge concerning the incidence of acute hemorrhagic nephritis is largely based on data from hospital statistics. Clinical Course The clinical course of acute nephritis indicates that between 90 and 95 per cent of children with this disease recover completely; 3 to 5 per cent die, usually in the acute phase during the first week of the disease, and that the remaining 2 to 5 per cent develop chronic glomerulonephritis. Few patients with glomerulonephritis have a long latent interval following the acute phase, with subsequent chronic glomerulonephritis; the chronic form of the disease usually occurs, if at all, within a few years of the initial episode. Few if any patients with acute glomerulonephritis in childhood subsequently develop the nephrotic syndrome. The nephrotic syndrome has been observed only following explosive onsets of acute nephritis associated with variable periods of anuiria, and obvious extensive nephron damage.