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Poststreptococcal glomerulonephritis

Patrick Niaudet, MD
Section Editor
F Bruder Stapleton, MD
Deputy Editor
Melanie S Kim, MD


Poststreptococcal glomerulonephritis (PSGN) is caused by prior infection with specific nephritogenic strains of group A beta-hemolytic streptococcus. The clinical presentation of PSGN varies from asymptomatic, microscopic hematuria to the full-blown acute nephritic syndrome, characterized by red to brown urine, proteinuria (which can reach the nephrotic range), edema, hypertension, and acute kidney injury. The prognosis is generally favorable, especially in children, but in some cases, the long-term prognosis is not benign.

The clinical manifestations, diagnosis, management, course of disease, and prognosis of PSGN will be reviewed here. Evaluation and causes of other glomerular disease in children are discussed separately. (See "Evaluation of a child with glomerular disease" and "Overview of the pathogenesis and causes of glomerulonephritis in children".)


Although PSGN continues to be the most common cause of acute nephritis in children globally, it primarily occurs in developing countries. Of the estimated 470,000 new annual cases of PSGN worldwide, 97 percent occur in regions of the world with poor socioeconomic status, with an annual incidence that ranges from 9.5 to 28.5 per 100,000 individuals [1,2].

In more developed and industrialized countries, the incidence has continued to decrease from the 1970s to the 1990s [2-4]. Based upon data from the Italian Registry of Renal Biopsies, the estimated annual incidence was 0.3 per 100,000 individuals between 1992 and 1994 [5]. The reasons may include the easier access to the treatment of streptococcal infections and the widespread presence of fluoride in water, which decreases virulence factors of Streptococcus pyogenes [6].

The risk of PSGN is increased in older patients (greater than 60 years of age) and in children between 5 and 12 years of age [5,7]. PSGN is uncommon in children less than three years of age. PSGN is twice as frequent in males as in females [8,9].

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Literature review current through: Sep 2017. | This topic last updated: Oct 31, 2016.
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