Membranoproliferative glomerulonephritis in childhood: Factors affecting prognosis

Membranoproliferative glomerulonephritis (MPGN) is a distinctive form of chronic glomerulonephritis. We present the results of our 96 paediatric patients with MPGN, reporting the survival and factors affecting prognosis in these patients. There were 64 boys and 32 girls with an age range of 2-17 (mean 10.6±3.7) years. All patients initially received oral corticosteroid therapy; remission was achieved in 22.9%. The unresponsive 77.1% either received cyclophosphamide and/or pulse methylprednisolone; 25.4% and 50.0% of these patients entered complete remission, respectively. The overall 1-year renal survivals of the MPGN patients were 90.1%, 5-year and 10-year survival rates were 81.9% and 61%, respectively. At multivariate analysis the factors affecting renal prognosis were haematuria at presentation (p<0.05, risk factor 3.52), urinary protein/creatinine ratio (p<0.05, risk factor 1.06 per 1 unit) and low haemoglobin values (p<0.05, risk factor 1.43 for each 1 g/dl decrement). We suggest that more aggressive immunosuppressive therapy should be instituted in patients unresponsive to steroids and that the aforementioned risk factors are higher for the development of renal failure.