The aim of this study was to evaluate the main characteristics of a clinical presentation and a long term prognosis of acute poststreptococcal glomerulonephritis (APSGN) during the 8 years' period (1994-2001) in the Orenburg regional children's hospital in Russia. Orenburg region is a part of the South Ural with the general population of 2220000 people. 266 patients with APSGN were observed during the study period.
The main age group was of 4-13 years (82%), only 4,1% of patients were younger than 4 years of age. Girls and boys ratio was 1: 1,7. Most patients had APSGN after impetigo (48%, including 4,1% of those after scabies) and respiratory infection (31%). Other preceding illnesses were: an infected wound (in 9,4%), a lymphadenitis (in 6,4%), a scarlet fever (in 3,4%), an acute appendicitis (in 1,5%). In 72,2% of patients etiology of streptococcal infection was confirmed by rise of antistreptolysin O titer or positive culture. Most of patients showed hematuria (92,1%), edema (81,2%) hypertension (63,9%) and renal failure (59%). 3% had encephalopathy.
128 patients were included in the prognostic study. All of them were with typical clinical course and serological confirmation for antecedent streptococcal infection. Such patients were followed up between 4-9 years (mean 5,3). All of them underwent the thorough physical examination including the blood pressure measurement. Morning urine was examined for erythrocytes and protein. The renal function was determined using creatinine clearance. None of patients had any abnormalities in blood pressure, urine analysis and creatinine clearance.
Conclusion: in Orenburg region APSGN is associated with high incidence of streptococcal infections. The disease has the classical clinical picture and the good long term prognosis.
