title: Prognosis of acute post-streptococcal glomerulonephritis in Sudanese children.
abstract: BACKGROUND
  Acute post streptococcal glomerulo-nephritis (APSGN) is a form of acute nephritic syndrome characterized by edema, hematuria, proteinuria, and hypertension. The immediate prognosis of acute post-streptococcal glomerulonephritis in children is usually excellent, however, the long-term prognosis has been a subject of debate.
  
  
  METHODS
  This is a retrospective and prospective cohort study of Sudanese children with APSGN followed in a tertiary care hospital between 2006 and 2010. Patients who presented for follow-up 1-5 years after initial diagnosis were assessed for proteinuria, hematuria, urinary albumin to creatinine ratio (ACR), hypertension, and glomerular filtration rate (GFR).
  
  
  RESULTS
  Data of 69 children (46 males; 66.7%) was analyzed. At presentation, 29% had severe acute disease requiring dialysis. On discharge, 60 children (87%) recovered their renal function, seven children (10.1%) showed no recovery and two children (2.9%) died. Forty out of 69 children presented to follow-up 1-5 years after initial diagnosis. Thirty-four of these children (85%) had normal blood pressure and GFR while six children (15%) progressed to chronic kidney disease (CKD); three of whom died. Among children with normal GFR, eight (23.5%) had microalbuminuria plus hematuria and four (11.7%) had hematuria. Persistence of proteinuria and/or hematuria was universal among the 14 children with normal GFR who continued follow-up more than three years after initial presentation.
  
  
  CONCLUSIONS
  APSGN in this group of Sudanese children had a less favorable prognosis. This reflects the tertiary care set-up of this study. Persistence of hematuria and/or proteinuria was common on follow-up.
authors.affiliation: Department of Pediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
authors.forename: El-Tigani M A
authors.initials: el-TM
authors.lastname: Ali
authors.affiliation: Department of Pediatrics, Soba University Hospital, Khartoum, Sudan.
authors.forename: Amal M T A
authors.initials: AM
authors.lastname: Babikir
authors.affiliation: Omdurman Children Hospital, Khartoum, Sudan.
authors.forename: Somayya
authors.initials: S
authors.lastname: El-Assad
authors.affiliation: Department of Pediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
authors.forename: Mohamed B
authors.initials: MB
authors.lastname: Abdelrahim
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D044383:Black People; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology; D006435:Renal Dialysis; D012189:Retrospective Studies