Wong William, Morris Maxwell Clarke, Zwi Jonathan
Department of Nephrology, Starship Children's Hospital, Auckland, New Zealand.
Pediatr Nephrol. 2009 May;24(5):1021-6. doi: 10.1007/s00467-008-1086-5. Epub 2008 Dec 19.
Post-streptococcal glomerulonephritis (PSGN) is the commonest cause of severe acute glomerulonephritis in New Zealand children, with the majority (85%) of the patients being of either Pacific Island or Maori ethnicity. We have performed a retrospective study on 27 pediatric patients with acute PSGN. Of these patients, those with crescentic glomerulonephritis (n = 11) had a greater tendency (72.7%) for needing acute dialysis and were left with persistent urinary sediment abnormalities after a mean follow-up of 3.2 years (95% confidence interval 2.1-4.3). The efficacy of immunosuppression in the group with crescentic disease was uncertain. The severity of renal histopathological abnormalities as judged by the total biopsy score did not correlate with either presentation or eventual outcome. Severe childhood acute post-streptococcal glomerulonephritis, although uncommon, results in significant long-term renal morbidity, particularly among Maori and Pacific Island children.
链球菌感染后肾小球肾炎（PSGN）是新西兰儿童严重急性肾小球肾炎最常见的病因，大多数（85%）患者为太平洋岛民或毛利族裔。我们对27例急性PSGN患儿进行了一项回顾性研究。在这些患者中，新月体性肾小球肾炎患者（n = 11）需要进行急性透析的倾向更大（72.7%），并且在平均3.2年的随访后（95%置信区间2.1 - 4.3）仍存在持续性尿沉渣异常。新月体性疾病组免疫抑制的疗效尚不确定。根据活检总分判断的肾脏组织病理学异常严重程度与临床表现或最终结局均无相关性。严重的儿童急性链球菌感染后肾小球肾炎虽然不常见，但会导致显著的长期肾脏疾病，尤其是在毛利族和太平洋岛民儿童中。
