Effect of overweight/obesity on recovery after post-infectious glomerulonephritis.
BACKGROUND
Children with post-infectious glomerulonephritis (PIGN) rapidly recover and have excellent long-term outcomes. After encountering several overweight/obese children with persistent urinary abnormalities during recovery from PIGN, we conducted this retrospective study to determine if overweight/obese status prolonged time to resolution of renal abnormalities after PIGN.


METHODS
Records of 20 children with PSGN evaluated between 1/98 and 12/05 were abstracted for demographics, clinical and laboratory data. Primary outcome measures were time to resolution of hypertension, proteinuria, microhematuria, and low complement C3. The effect of overweight/obese status on outcomes was determined using Kaplan Meier Survival and the log-rank test.


RESULTS
The median age was 8 years; 30% were overweight/obese. At presentation, 17 (85%) were hypertensive, 10 (50%) had impaired glomerular filtration (GFR), and 18 (90%) had proteinuria. At last follow-up (median 2.8 months) 12% had hypertension, 55% had microhematuria, 5% had proteinuria but none had low GFR. Median time to normalize was: 30 days (GFR), 45 days (blood pressure), 6 weeks (C3) and 6 months (microhematuria). Log rank test showed that proteinuria-, hypertension-, and hematuria-free survival were all lower in children who were overweight/obese although none of the differences were statistically significant. Time to normalization of C3 was shorter in obese/ overweight children.


CONCLUSIONS
In conclusion, overweight/obese children appear to have greater residual renal injury after PIGN. The earlier C3 normalization in overweight/ obese children may indicate that the adverse effect of weight on recovery is from hemodynamic rather than inflammatory factors. Close follow-up of overweight/obese children who develop PIGN is warranted to ensure optimal long-term outcomes.
Lee
M N
MN
Department of Pediatrics, and 2Section of Pediatric Nephrology, Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA, USA.
Shaikh
U
U
Butani
L
L
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000150:complications* / Q000175:diagnosis; D006417:Hematuria / Q000150:complications / Q000175:diagnosis; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis; D007239:Infections / Q000150:complications* / Q000175:diagnosis; D008297:Male; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D011379:Prognosis; D011507:Proteinuria / Q000150:complications* / Q000175:diagnosis; D020127:Recovery of Function; D012189:Retrospective Studies