Objective: Studies on acute glomerulonephritis (AGN) in Nigeria described the epidemiological profile without an in-depth analysis of variables associated with outcomes. Herein, we describe the profile and factors associated with hospitalization outcomes (discharge or death) among childhood AGNs at a health facility in northwestern Nigeria.
Material and Methods: This prospective cross-sectional study was conducted between 1st January 2018 and 31st December 2019 at a tertiary health facility in northwestern Nigeria. The diagnosis of AGN was based on a clinical diagnosis. We also obtained relevant history, clinical, and laboratory features.
Results: Thirty-five children were admitted with AGN during the study period. The mean age was 7.7 ± 3.3 years. Most were aged 5 to 10 years (23; 65.7%), male (60.0%), and from a lower socio-economic class (77.2%). The annual incidence of AGN was 11 cases per 1000 children. The most common clinical presentations were generalized body swelling (100.0%), reduced urine output (85.7%), and hypertension (74.3%). The medians (interquartile range) of urea and creatinine were 10.0 (4.50 to 23.90) mmol/L and 85 (67.60 to 204.00) µmol/L, respectively. Among the clinical features, only fever was associated with outcomes, while serum urea and creatinine levels were significantly higher among non-survivors, p<0.05. We recorded four deaths (case fatality rate of 11.4%), two each from congestive cardiac failure and hypertensive encephalopathy.
Conclusion: This study shows a high incidence of childhood AGN and mortality in Katsina, northwestern Nigeria. Fever was associated with outcomes, while serum creatinine and urea levels were elevated among non-survivors.
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Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Pediatr Nephrol. 2011;26(2):165-80. doi:10.1007/s00467-010-1554-6 google scholar
Guo Q, Wu S, Xu C, Wang J, Chen J. Global Disease Burden From Acute Glomerulonephritis 1990-2019. Kidney Int Reports. 2021;6(8):2212-7. doi:10.1016/j.ekir.2021.04.038 google scholar
Alhamoud MA, Salloot IZ, Mohiuddin SS, AlHarbi TM, Batouq F, Alfrayyan NY, et al. A Comprehensive Review Study on Glomerulonephritis Associated With Post-streptococcal Infection. Cureus. 2021;13(12):6-12. doi:10.7759/cureus.20212 google scholar
Aikhonbare H, Abdurrahman MB. Acute Glomerulonephritis in Zaria. Niger J Paediatr. 1984;11(2):59-62. google scholar
Garba BI, Muhammad AS, Obasi AB, Adeniji AO. Presentation and pattern of childhood renal diseases in Gusau, North-Western Nigeria. South African J Child Heal. 2017;11(2):96. doi:10.7196/ SAJCH.2017.v11i2.1222 google scholar
Anigilaje EA, Adesina TC. The pattern and outcomes of childhood renal diseases at University of Abuja Teaching Hospital, Abuja, Nigeria: A 4 year retrospective review. Niger Postgrad Med J. 2019;26(1):53. doi:10.4103/npmj.npmj_174_18 google scholar
Asinobi AO, Ademola AD, Nwankwo AF. Childhood acute glomerulonephritis in Ibadan Nigeria. Niger J Paediatr. 2020;47(4):345-52. doi:10.4314/njp.v47i4.8 google scholar
Anochie I, Eke F, Okpere A. Childhood acute glomerulonephritis in Port Harcourt, Rivers State, Nigeria. Niger J Med. 2009;18(2):162-7. doi:10.4314/njm.v18i2.45056 google scholar
Okafor HU, Okoro BA, Ugwu G. Acute Glomerulonephritis in Enugu. Niger J Paediatr. 1995;22(2):31-5. google scholar
Kanjanabuch T, Kittikowit W, Eiam-Ong S. An update on acute postinfectious glomerulonephritis worldwide. Nat Rev Nephrol. 2009;5(5):259-69. doi:10.1038/nrneph.2009.44 google scholar
Oyedeji GA. Socio-economic and cultural background of hospitalised children in Ilesha. Niger J paed. 1985;12(4):111-7. google scholar
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents.The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555-76. google scholar
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Kidney disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(1):1-138. doi:10.1038/kisup.2012.1 google scholar
Dowler J, Wilson A. Acute post-streptococcal glomerulonephritis in Central Australia. Aust J Rural Health. 2019;28(1):74-80. doi:10.1111/ajr.12568 google scholar
National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey 2018.; 2019. https://dhsprogram. com/pubs/pdf/PR118/PR118.pdf google scholar
Syamsul N, Husein A, Darsil D. Paediatrica Indonesiana. Paediatr Indones. 2016;56(3):167-70. doi:10.14238/pi google scholar
Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: An update. Curr Opin Pediatr. 2008;20(2):157-62. doi:10.1097/ MOP.0b013e3282f45bcf google scholar
Hurtado A, Johnson RJ. Hygiene hypothesis and prevalence of glomerulonephritis. Kidney Int Suppl. 2005;68(97):62-7. doi:10.1111/j.1523-1755.2005.09711.x google scholar
Etuk IS, Anah MU, Eyong ME. Epidemiology and clinical features of acute glomerulonephritis in Calabar, Nigeria. Niger J Physiol Sci. 2009;24(2):91-4. doi:10.4314/njps.v24i2.52913 google scholar
Ugwu GIM, Mcgil Ugwu GI. Renal Data from Asia-Africa Acute Glomerulonephritis in Children of the Niger Delta Region of Nigeria. Saudi J Kidney Dis Transpl. 2015;26(5):1064-9. http:// www.sjkdt.org google scholar
Khadijat Omeneke I, Ben Oloche O, Asmau A, Fatima Bello J, Maryam A-S, Bilkisu Ilah G, et al. Delayed Presentation and Outcome of Febrile Children Admitted in a Tertiary Facility in Sokoto, North-Western Nigeria: A Case-Control Study. Int J Pediatr Res. 2020;6(1):063. doi:10.23937/2469-5769/1510063 google scholar
Lamesginew M, Damte S. Outcomes of children with acute post streptococcal glomerulonephritis in Tikur Anbessa specialised teaching hospital, Addis Ababa, Ethiopia. Ethiop J Pediatr Child Heal. 2012;8(8). google scholar
Shahidul Islam Bhuiyan ANM, Alam Z, Zahirul Hasan K, Mostafa Zaman M, Zakaria M. A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children. Am J Pediatr. 2020;6(4):448-54. doi:10.11648/j.ajp.20200604.20 google scholar
Van De Voorde RG. Acute poststreptococcal glomerulonephritis: The most common acute glomerulonephritis. Pediatr Rev. 2015;36(1):3-13. doi:10.1542/pir.36-1-3 google scholar
Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Pediatr Nephrol. 2011;26(2):165-80. doi:10.1007/s00467-010-1554-6 google scholar
Guo Q, Wu S, Xu C, Wang J, Chen J. Global Disease Burden From Acute Glomerulonephritis 1990-2019. Kidney Int Reports. 2021;6(8):2212-7. doi:10.1016/j.ekir.2021.04.038 google scholar
Alhamoud MA, Salloot IZ, Mohiuddin SS, AlHarbi TM, Batouq F, Alfrayyan NY, et al. A Comprehensive Review Study on Glomerulonephritis Associated With Post-streptococcal Infection. Cureus. 2021;13(12):6-12. doi:10.7759/cureus.20212 google scholar
Aikhonbare H, Abdurrahman MB. Acute Glomerulonephritis in Zaria. Niger J Paediatr. 1984;11(2):59-62. google scholar
Garba BI, Muhammad AS, Obasi AB, Adeniji AO. Presentation and pattern of childhood renal diseases in Gusau, North-Western Nigeria. South African J Child Heal. 2017;11(2):96. doi:10.7196/ SAJCH.2017.v11i2.1222 google scholar
Anigilaje EA, Adesina TC. The pattern and outcomes of childhood renal diseases at University of Abuja Teaching Hospital, Abuja, Nigeria: A 4 year retrospective review. Niger Postgrad Med J. 2019;26(1):53. doi:10.4103/npmj.npmj_174_18 google scholar
Asinobi AO, Ademola AD, Nwankwo AF. Childhood acute glomerulonephritis in Ibadan Nigeria. Niger J Paediatr. 2020;47(4):345-52. doi:10.4314/njp.v47i4.8 google scholar
Anochie I, Eke F, Okpere A. Childhood acute glomerulonephritis in Port Harcourt, Rivers State, Nigeria. Niger J Med. 2009;18(2):162-7. doi:10.4314/njm.v18i2.45056 google scholar
Okafor HU, Okoro BA, Ugwu G. Acute Glomerulonephritis in Enugu. Niger J Paediatr. 1995;22(2):31-5. google scholar
Kanjanabuch T, Kittikowit W, Eiam-Ong S. An update on acute postinfectious glomerulonephritis worldwide. Nat Rev Nephrol. 2009;5(5):259-69. doi:10.1038/nrneph.2009.44 google scholar
Oyedeji GA. Socio-economic and cultural background of hospitalised children in Ilesha. Niger J paed. 1985;12(4):111-7. google scholar
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents.The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555-76. google scholar
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Kidney disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(1):1-138. doi:10.1038/kisup.2012.1 google scholar
Dowler J, Wilson A. Acute post-streptococcal glomerulonephritis in Central Australia. Aust J Rural Health. 2019;28(1):74-80. doi:10.1111/ajr.12568 google scholar
National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey 2018.; 2019. https://dhsprogram. com/pubs/pdf/PR118/PR118.pdf google scholar
Syamsul N, Husein A, Darsil D. Paediatrica Indonesiana. Paediatr Indones. 2016;56(3):167-70. doi:10.14238/pi google scholar
Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: An update. Curr Opin Pediatr. 2008;20(2):157-62. doi:10.1097/ MOP.0b013e3282f45bcf google scholar
Hurtado A, Johnson RJ. Hygiene hypothesis and prevalence of glomerulonephritis. Kidney Int Suppl. 2005;68(97):62-7. doi:10.1111/j.1523-1755.2005.09711.x google scholar
Etuk IS, Anah MU, Eyong ME. Epidemiology and clinical features of acute glomerulonephritis in Calabar, Nigeria. Niger J Physiol Sci. 2009;24(2):91-4. doi:10.4314/njps.v24i2.52913 google scholar
Ugwu GIM, Mcgil Ugwu GI. Renal Data from Asia-Africa Acute Glomerulonephritis in Children of the Niger Delta Region of Nigeria. Saudi J Kidney Dis Transpl. 2015;26(5):1064-9. http:// www.sjkdt.org google scholar
Khadijat Omeneke I, Ben Oloche O, Asmau A, Fatima Bello J, Maryam A-S, Bilkisu Ilah G, et al. Delayed Presentation and Outcome of Febrile Children Admitted in a Tertiary Facility in Sokoto, North-Western Nigeria: A Case-Control Study. Int J Pediatr Res. 2020;6(1):063. doi:10.23937/2469-5769/1510063 google scholar
Lamesginew M, Damte S. Outcomes of children with acute post streptococcal glomerulonephritis in Tikur Anbessa specialised teaching hospital, Addis Ababa, Ethiopia. Ethiop J Pediatr Child Heal. 2012;8(8). google scholar
Shahidul Islam Bhuiyan ANM, Alam Z, Zahirul Hasan K, Mostafa Zaman M, Zakaria M. A Clinical Profile and Immediate Outcome of Acute Glomerulonephritis (AGN) in Hospitalized Children. Am J Pediatr. 2020;6(4):448-54. doi:10.11648/j.ajp.20200604.20 google scholar
Ibrahim, O. . R., Aladesua, O., Alao, M. A., Alege, A. (2024). Profile and Outcomes of Children with Acute Glomerulonephritis in Northwestern Nigeria. Çocuk Dergisi, 23(4), 327-333. https://doi.org/10.26650/jchild.2023.1231820
AMA
Ibrahim OR, Aladesua O, Alao MA, Alege A. Profile and Outcomes of Children with Acute Glomerulonephritis in Northwestern Nigeria. Çocuk Dergisi. February 2024;23(4):327-333. doi:10.26650/jchild.2023.1231820
Chicago
Ibrahim, Olayinka Rasheed, Olajide Aladesua, Michael Abel Alao, and Abdurrazzaq Alege. “Profile and Outcomes of Children With Acute Glomerulonephritis in Northwestern Nigeria”. Çocuk Dergisi 23, no. 4 (February 2024): 327-33. https://doi.org/10.26650/jchild.2023.1231820.
EndNote
Ibrahim OR, Aladesua O, Alao MA, Alege A (February 1, 2024) Profile and Outcomes of Children with Acute Glomerulonephritis in Northwestern Nigeria. Çocuk Dergisi 23 4 327–333.
IEEE
O. . R. Ibrahim, O. Aladesua, M. A. Alao, and A. Alege, “Profile and Outcomes of Children with Acute Glomerulonephritis in Northwestern Nigeria”, Çocuk Dergisi, vol. 23, no. 4, pp. 327–333, 2024, doi: 10.26650/jchild.2023.1231820.
ISNAD
Ibrahim, Olayinka Rasheed et al. “Profile and Outcomes of Children With Acute Glomerulonephritis in Northwestern Nigeria”. Çocuk Dergisi 23/4 (February 2024), 327-333. https://doi.org/10.26650/jchild.2023.1231820.
JAMA
Ibrahim OR, Aladesua O, Alao MA, Alege A. Profile and Outcomes of Children with Acute Glomerulonephritis in Northwestern Nigeria. Çocuk Dergisi. 2024;23:327–333.
MLA
Ibrahim, Olayinka Rasheed et al. “Profile and Outcomes of Children With Acute Glomerulonephritis in Northwestern Nigeria”. Çocuk Dergisi, vol. 23, no. 4, 2024, pp. 327-33, doi:10.26650/jchild.2023.1231820.
Vancouver
Ibrahim OR, Aladesua O, Alao MA, Alege A. Profile and Outcomes of Children with Acute Glomerulonephritis in Northwestern Nigeria. Çocuk Dergisi. 2024;23(4):327-33.