ArticleCureus2026
Prognostic Significance of Nephrotic-Range Proteinuria in Paediatric Acute Glomerulonephritis.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcute glomerulonephritis (AGN) in paediatric patients typically presents with haematuria, oedema, hypertension, oliguria, and a decline in renal function attributable to immune‑mediated glomerular injury. A subset of patients presents with nephrotic-range proteinuria at onset, termed nephritic-nephrotic syndrome, the prognostic implications of which remain underexplored.
methodsA prospective observational study was conducted in the departments of paediatrics and paediatric nephrology at a tertiary care centre in Odisha over two years. Children aged 1-14 years with a clinical diagnosis of AGN were enrolled and evaluated for demographic, clinical, and laboratory parameters. Patients with nephrotic-range proteinuria at presentation were analysed as a distinct subgroup. Clinical course, complications, and outcomes were compared between nephritic-nephrotic and classical nephritic presentations.
resultsSeventy children were included (53 males, 17 females); the majority were aged 5-10 years. Facial puffiness (100%), haematuria (68.6%), and pedal oedema (64.3%) were the most frequent presenting features. A preceding infection was documented in 85.7%, commonly pharyngitis (58.6%) or skin infection (27.1%). Nephrotic-range proteinuria was observed in 15 patients (21%). Complications on admission were more frequent in this subgroup, including hypertensive encephalopathy (60% vs. 9.1%), congestive cardiac failure (60% vs. 16.4%), and acute kidney injury (60%% vs. 21.8%). There were many signs and symptoms overlapping in both hypertensive encephalopathy and congestive cardiac failure in nephrotic-range proteinuria patients. At the three-month follow-up, children with nephrotic-range proteinuria were found to develop persistent hypertension.
conclusionPaediatric AGN with nephrotic-range proteinuria represents a high-risk phenotype associated with a more severe clinical course, greater complication rates, and may have adverse long-term renal outcomes. Early recognition and close follow-up of this subgroup are essential for timely intervention and improved prognosis.
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