Outcomes and Predictors of Acute Post‐Streptococcal Glomerulonephritis in Hospitalized Children in Northwest Ethiopia: A Multicenter Retrospective Cohort Study

Abstract

ABSTRACT Background Acute post‐streptococcal glomerulonephritis (APSGN) is one of the most critical health conditions. It remains an important cause of acute kidney injury, hospitalization, and long‐term complications for children. Thus, this study aimed to assess the treatment outcome of APSGN and its predictors among pediatric patients at Comprehensive Specialized Hospitals in Northwest Ethiopia. Methods An institutional retrospective cohort study was conducted on pediatric patients, reviewing medical records from admission to treatment outcome between September 01, 2018, and August 30, 2024. The collected data were entered using the Epi Data software (version 4.6.0.0) and exported to SPSS version 25.0. Adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) and p value < 0.05 were used to identify significant factors affecting the treatment outcome. Results Most patients with acute post‐streptococcal glomerulonephritis demonstrated positive treatment outcomes, with 70.2% recovering completely. The majority of patients arrived at the hospital more than 2 weeks after infection, with 70.8% hospitalized for over 2 weeks. Children aged 5–9 years faced significantly higher odds of negative outcomes (AOR = 2.61, 95% CI: 1.34–5.10, p = 0.006), while those aged 10–15 years did not show a significant association. Acute kidney injury (AOR = 1.70, 95% CI: 1.08–2.93, p = 0.032) and an infection duration over 2 weeks (AOR = 2.14, 95% CI: 1.06–4.32, p = 0.024) were linked to worse outcomes. Additionally, an evident source of infection was associated with negative outcomes (AOR = 2.13, 95% CI: 1.25–5.13). Conclusion The majority of patients with acute post‐streptococcal glomerulonephritis recovered completely. Significant predictors of negative treatment outcomes included age, the evident source of infection, the duration of infection at admission, and the presence of acute kidney infection at admission. There should be a focus on treatment outcomes through thorough evaluation, follow‐up, and monitoring.