Epidemiology, Diagnosis and Outcomes of Acute Post-infectious Glomerulonephritis in Children in Dakar, Senegal

Background: Acute post infectious glomerulonephritis (APIGN) is the most common cause of glomerulonephritis in developing countries. Its epidemiology, diagnosis, clinical management and outcome aspects remain poorly documented in Senegal. Methods: We conducted a retrospective, three centers, descriptive and analytical study from January 1, 2018 to December 31, 2022 on children under 16 years old. Results: APIGN accounted for 0.4%(n=87) of all paediatric hospitalizations and pathologies with variation between hospitals. The prevalence of APIGN was 15.8% among all renal pathologies. Haematuria (100%) and renal oedema (80.5%) were the main symptoms on admission. 64.4% of the children presented with life threatening hypertension. 80 children (92%) had acute kidney injury. More than half of the children (53.8%) had a low C3 complement level. ASLO tests were positive in 19.5% of children. In most cases (66.7%), the etiology of APIGN was undetermined however impetiginized scabies was found in 16.1% of cases. Furosemide was administered in 67.8% of cases. Cephalosporins were the main antibiotics (32.2%). Oral corticosteroids were used in 20 children (23.0%). Dialysis was performed in 6 children (6.7%). The outcome was favourable in 81 children (93.1%), 2 (2.3%) developed chronic renal failure, and 4 (4.6%) died. Risk factors associated with poor outcome were hyponatremia (p = 0.019) and hyperkalemia (p = 0.001). Conclusion: Acute post-infectious glomerulonephritis remains common in our setting. Its causes are not always identified however, the presence of acute nephritic syndrome should prompt investigation for complications such as hyponatremia and hyperkalaemia, which can worsen the course of the disease.