Clinicopathological and laboratory profile of infection-related glomerulonephritis in children. A prospective observational study.

Background Infection-related glomerulonephritis (IRGN) remains an important cause of acute nephritic syndrome in children and continues to contribute to admissions for hypertension, edema, and renal dysfunction in many low- and middle-income settings. Objectives: To describe the clinicopathological and laboratory profile of pediatric IRGN and to document early outcomes over six weeks. Methods A prospective observational study was conducted in a tertiary pediatric unit from August 2022 to February 2024. Children aged 1 month to 18 years presenting with acute nephritic features suggestive of IRGN were enrolled. Urinalysis, spot urine protein–creatinine ratio, renal function tests, complement (C3/C4), and antistreptolysin O (ASO) titres were obtained, and renal biopsy was performed when clinically indicated. Participants were followed for six weeks. Results A total of 158 children were included (mean age 7.87 ± 3.50 years). Antecedent infection was documented in 79.1%. Hematuria occurred in 89.9%, oliguria in 70.3%, and hypertension in 55.1%. Low complement levels were observed in 58.2% and ASO titres were positive in 62.0%. Renal biopsy was required in 12.0% and commonly showed proliferative patterns. At six weeks, complete recovery occurred in 67.1%; persistent hematuria, persistent proteinuria, and persistent hypertension were noted in 17.7%, 8.2%, and 7.0%, respectively. Conclusion Pediatric IRGN showed a predominantly nephritic presentation with frequent complement activation and generally favorable short-term outcomes. Early recognition of severe features and structured follow-up help detect complications and residual abnormalities. Recommendations Standardize early testing for proteinuria and complement status, and prioritize rapid blood pressure control and fluid management. Arrange follow-up visits to confirm resolution of hematuria, proteinuria, and hypertension.