Prospective population-based study on the burden of disease from post-streptococcal glomerulonephritis of hospitalised children in New Zealand: epidemiology, clinical features and complications

J Paediatr Child Health. 2013 Oct;49(10):850-5. doi: 10.1111/jpc.12295. Epub 2013 Jun 18.


Aim: A nationwide 24-month study was conducted (2007-2009), via the New Zealand Paediatric Surveillance Unit to define epidemiology and clinical features of acute poststreptococcal glomerulonephritis (APSGN) in children hospitalised with the illness.

Methods: Paediatricians (n = 215) were requested to report new hospitalised cases fulfilling a case definition of definite (haematuria with low C3 and high streptococcal titres or biopsy proven APSGN) or probable (haematuria with low C3 or high streptococcal titres).

Results: A total of 176 cases were identified (definite: n = 138, probable: n = 38) with 63% residing in the Auckland metropolitan region. Sixty-seven percent were in the most deprived quintile. Annual incidence (0-14 years) was 9.7/100,000 (Pacific 45.5, Maori 15.7, European/other 2.6 and Asian 2.1/100,000). Annual incidence was highest in the South Auckland Metropolitan region (31/100,000), Central Auckland 14.9, West/North Auckland metropolitan region 5.9 and for the remainder of New Zealand 5.5/100,000. Age-specific incidence was highest in age 5-9 years (15.1/100,000). Reduced serum complement C3, gross haematuria, hypertension, impairment of renal function and heavy proteinuria were present in 93%, 87%, 72%, 67% and 44% of patients, respectively. Severe hypertension was closely associated with either symptoms of an acute encephalopathy or congestive heart failure.

Conclusions: New Zealand children carry a significant disease burden of hospitalised APSGN with socio-economically deprived; Pacific and Maori children are being over-represented. Significant short-term complications were observed in hospitalised children with APSGN. Persistently very low rates in European/other suggest a preventable disease.

Keywords: New Zealand; epidemiology; post-streptococcal glomerulonephritis.

MeSH terms

  • Adolescent
  • Brain Diseases / etiology
  • Child
  • Child, Preschool
  • Cost of Illness*
  • Female
  • Glomerulonephritis / complications
  • Glomerulonephritis / epidemiology*
  • Glomerulonephritis / ethnology
  • Heart Failure / etiology
  • Hospitalization
  • Humans
  • Hypertension / etiology
  • Incidence
  • Infant
  • Male
  • New Zealand / epidemiology
  • Prospective Studies
  • Streptococcal Infections / complications*