Abstract
Background: Rapidly progressive glomerulonephritis (RPGN) is a condition characterized by clinical evidence of glomerulonephritis and rapid progressive decline in kidney function. The prognosis for most children with postinfectious crescentic glomerulonephritis is generally favorable. There is scarcity of data regarding outcome of RPGN in local pediatric population. Objectives: To determine different etiologies and compare the outcome of crescentic glomerulonephritis in children. Methods: This was Quantitative, prospective, cross-sectional study conducted in Department of Pediatric Nephrology, University of Child Health Sciences within duration n of one year. Thirty children with biopsy proven RPGN were enrolled. Causes of RPGN were evaluated. All children received treatment with intravenous methylprednisolone pulses for 3 days followed by oral prednisone. All subjects were followed-up for 6 months to assess response to treatment and to evaluate outcome. Data was analyzed in SPSS version 25.0. Results: Mean age of children was 9.07 ± 2.82 years. There were 18 (60%) males and 12 (40%) females. Out of 30 children, 1 (3.3%) each had anti-GBM disease and ANCA associated vasculitis, 5 (16.7%) had Lupus nephritis, 11 (36.7%) had Pauci-immune glomerulonephritis, and 12 (40%) patients developed RPGN due to post-infectious glomerulonephritis. Complete response to treatment was noted in 1 (3.3%) patient after 1 month and in 16 (53.3%) children at 3 months of follow up. 18 (60%) cases achieved complete remission at 6 months, while 7 (23.3%) required hemodialysis for CKD. Rituximab was given to one patient after 6 months of treatment. Plasmapheresis was done in patient with anti-GBM disease. Conclusion: Most common cause of rapidly progressive glomerulonephritis (RPGN) was post-infectious glomerulonephritis followed by pauci-immune and lupus glomerulonephritis. Clinical presentation and outcome varied depending on the underlying etiology and type and / or number of glomerular crescents found on renal pathology.