Delay in Diagnosis in Poststreptococcal Glomerulonephritis

Objective To determine the frequency and risk factors for diagnostic delays in children with poststreptococcal glomerulonephritis (PSGN). Study design We reviewed the charts of 52 children with PSGN, and identified children with a delay in diagnosis of more than 24 hours. We determined risk factors...

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Bibliographic Details
Published in:The Journal of pediatrics 2008-10, Vol.153 (4), p.560-564
Main Authors: Pais, Priya J., MD, Kump, Theresa, BA, Greenbaum, Larry A., MD, PhD
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
Child, Preschool
Female
General aspects
Glomerulonephritis
Glomerulonephritis - complications
Glomerulonephritis - diagnosis
Glomerulonephritis - microbiology
Glomerulonephritis - physiopathology
Humans
Hypertension - etiology
Logistic Models
Male
Medical sciences
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Pediatrics
Retrospective Studies
Risk Factors
Streptococcal Infections - complications
Time Factors
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Summary:Objective To determine the frequency and risk factors for diagnostic delays in children with poststreptococcal glomerulonephritis (PSGN). Study design We reviewed the charts of 52 children with PSGN, and identified children with a delay in diagnosis of more than 24 hours. We determined risk factors for delay in diagnosis using univariate and multivariate logistic regression. Results 17 children (33%) with PSGN had a delay in diagnosis. Delay in diagnosis occurred in 14% of children with gross hematuria as a presenting complaint and in 54% of children without gross hematuria as a presenting complaint (3.8 increased relative risk, 95% CI = 1.4 to 10; P = .02). A delay in diagnosis was more common in children with a negative infection history ( P = .04). In multiple logistic regression, only the absence of gross hematuria as a presenting complaint was associated with a delay in diagnosis ( P = .01). All children with a delay in diagnosis had microscopic hematuria on their initial urinalysis. Conclusions Delay in diagnosis is common in children with PSGN, especially if visible hematuria is not a presenting complaint. Physicians should consider the possibility of PSGN in children with symptoms that may be secondary to volume overload. A urinalysis is a helpful initial diagnostic test.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2008.04.021