Prognostic Factor of Ureum and Creatinine Serum of Acute Post Streptococcal Glomerulonephritis in Children

Abstract

Introduction: Acute post streptococcal glomerulonephritis is one of the commonest causes of glomerular disease in developing countries. Ureum and creatinine examination not only can be used to support the diagnosis but also to identify and detect early organs disturbances and predict the patient prognosis. Objective: This study aims to observe the ureum and creatinine serum level in APSGN children and its relationship with the outcomes. Methods: A retrospective cohort design regarding the prognostic value of serum ureum and creatinine levels for APSGN children outcomes. The data was collected from medical records of APSGN children treated at Dr. Wahidin Sudirohusodo Hospital Makassar from 2009-2013. Results: There is no significant correlation between the outcome and sex (p=0.961), nutritional status (p=1.000), and age (p=0.108). There is a significant difference both in early ureum levels to outcome with p=0.003 and in early creatinine levels to outcome with p=0.020. There is tendency to decreased levels of ureum and creatinine serum of survival group (p=0.000) while hospitalization and trend of increased or stagnan levels of ureum and creatinine serum of non survival group while hospitalization. Multivariate analyses indicated that serum ureum levels <119 mg/dl is an independent prognostic factor for APSGN outcomes in children with p=0.032, OR 1.021, and CI 95% 1.002-1.041. Conclusion: It seems that serum ureum is an independent prognostic factor for APSGN, where serum ureum levels <119 mg/dl and creatinine levels <1.3 mg/dl have a good prognosis. Out of the 95 patients as sampled, there were 90 (94.7%) cured, and 5 (5.2%) patients died.