Abstract Introduction THE PROGNOSIS of acute glomerulonephritis in children remains controversial. Manyauthors expect only 60%-70% of such patients to recover1-4; whereas others anticipate that 80%-90% will heal.5-8 These discrepancies aredifficult to evaluate because diagnostic criteria may not have been given,9-12 the number of cases may be small,13-16 or the period of followup may be short.2,17-19 A review of our experience at the Childrens Hospital of Los Angeles was undertaken to determine if the causes of these discrepancies could be eliminated or minimized. Rigid diagnostic criteria were used for inclusion of patients in this study insofar as possible to insure that only patients suffering from acute glomerulonephritis were considered. The historical, physical, and laboratory findings which constituted these criteria are presented in detail. Materials and Methods Selection of Patients.—The diagnostic criteria used for accepting a child in the study included the history of a previously healthy References 1. Snoke, A. W.: Stages, Prognosis and Duration of Glomerular Nephritis in Childhood , Amer J Dis Child 53:673, 1937. 2. Cass, J. M.: Ultimate Prognosis of Nephritis in Childhood—Together With Study of Incidence of Anemia in Various Stages of Disease , Arch Dis Child 14:137, 1939.Crossref 3. Clark, N. A.: Prognosis of Nephritis in Childhood , Arch Dis Child 31:156, 1956.Crossref 4. Snoke, A. W.: Prognosis of Glomerular Nephritis in Childhood , Amer J Dis Child 57:1373, 1939. 5. Davis, J. H., and Faber, H. K.: Prognosis in Acute Glomerulonephritis in Children , J Pediat 27:453, 1945.Crossref 6. McCrory, W. W.: " Glomerulonephritis in Childhood ," in Modern Problems of Pediatrics , Basel, Switzerland: S. Karger, A.G., 1960, vol 6, p 230. 7. Ellis, A.: Natural History of Bright's Disease , Lancet 1:11942.Crossref 8. Gachet, F. S.: Course and Prognosis of Hemorrhagic Nephritis in Children , Amer J Dis Child 61:1175, 1941. 9. DeLeeuw, K.: Prognosis of Nephritis in Children , Acta Pediat 20( (suppl 1) ):1, 1937.Crossref 10. Longcope, W. T.: Some Observations on Course and Outcome of Hemorrhagic Nephritis , New Int Clin 1:1, 1938. 11. Lyttle, J. D., and Rosenberg, L.: Treatment of Acute Glomerulonephritis in Children , Bull NY Acad Med 14:212, 1938. 12. Payne, W. W., and Illingworth, R. S.: Acute Nephritis in Childhood With Special Reference to Diagnosis of Focal Nephritis , Quart J Med 9:37, 1940. 13. Loeb, E. N., et al: On Permanence of Recovery in Acute Glomerulonephritis , J Clin Invest 17:623, 1938.Crossref 14. Pittinos, G. E.; Craig, J. D.; and DeSanctis, A. G.: Prognosis of Acute Hemorrhagic Nephritis in Childhood , JAMA 117:1855, 1941.Crossref 15. Edelmann, C. M., Jr.; Greifer, I.; and Barnett, H. L.: Nature of Kidney Disease in Children Who Fail to Recover From Apparent Acute Glomerulonephritis , J Pediat 64:879, 1964.Crossref 16. Hebert, H. J.: Acute Glomerulonephritis in Childhood: Study of Late Prognosis of 27 Cases , J Pediat 40:549, 1952.Crossref 17. Blumberg, R. W., and Feldman, D. B.: Observations on Acute Glomerulonephritis Associated With Impetigo , J Pediat 60:677, 1962.Crossref 18. Hutt, M. S. R., and White, R. H. R.: Clinico-Pathological Study of Acute Glomerulonephritis in East African Children , Arch Dis Child 39:313, 1964.Crossref 19. Burke, F. G., and Ross, S.: Acute Glomerulonephritis: Review of 90 Cases , J Pediat 30:157, 1947.Crossref 20. Gwinn, J. L.: Personal communication to the author. 21. Nemir, R. L., and Beranbaum, S. L.: Pulmonary Edema Occurring During Course of Renal Azotemia , Amer J Dis Child 95:516, 1958.Crossref 22. Holzel, A., and Fawcitt, J.: Pulmonary Changes in Acute Glomerulonephritis in Childhood , J Pediat 57:695, 1960.Crossref 23. Toro-Nazario, R. A., and Burke, E. C.: Pulmonary Congestion and Edema as Complication of Acute Nephritis in Childhood , Lancet 79:246, 1959. 24. Kirkpatrick, J. A., and Fleisher, D. S.: Roentgen Appearance of Chest in Acute Glomerulonephritis in Children , J Pediat 64:498, 1964. 25. Vernier, R. L., et al: Chronic Renal Disease in Children: Correlation of Clinical Findings With Morphologic Characteristics Seen by Light and Electron Microscopy , Amer J Dis Child 96:306, 1958.Crossref 26. Goldbloom, R. B., et al: Hereditary Renal Disease Associated With Nerve Deafness and Ocular Lesions , Pediatrics 20:241, 1957. 27. Perkoff, G. T., et al: Follow-Up Study of Hereditary Chronic Nephritis , Arch Intern Med 102:733, 1958.Crossref 28. Burke, E. C.: Chronic Nephritis in Children: Diagnostic Enigma , Proc Mayo Clin 34:591, 1959.
American Journal of Diseases of Children – American Medical Association
Published: May 1, 1965