Follow-up of patients with epidemic poststreptococcal glomerulonephritis

Follow-up of patients with epidemic poststreptococcal glomerulonephritis

Author Pinto, SWL Google Scholar
Sesso, R. Google Scholar
Vasconcelos, E. Google Scholar
Watanabe, Y. J. Google Scholar
Pansute, A. M. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract In 1998 there was a large outbreak of acute glomerulonephritis (GN) in Nova Serrana, Brazil, caused by group C Streptococcus zooepidemicus and linked to the consumption of contaminated cheese produced with unpasteurized milk. This study describes the follow-up of these patients after a mean of 2 years following the acute episode. of 134 patients identified in 1998, 69 patients were reexamined and underwent measurements of blood pressure, 24-hour creatinine clearance, microalbuminuria (radioimmunoassay), and urine sediment analysis. of the original group of 134 patients, 3 patients died in the acute phase and 5 patients (3.7%) required chronic dialysis. of 69 patients reevaluated, 65 patients (94%) were adults (mean age, 39 +/- 2 [SE] years) and 47 patients (68%) were women. At the follow-up examination, we found arterial hypertension in 42% of subjects (27 of 64 subjects), serum creatinine levels greater than 1.2 mg/dL in 12% (10 of 68 subjects), reduced creatinine clearance (>80 mL/min/1.73 m(2)) in 30% (20 of 67 subjects, 2 of them on chronic dialysis therapy), and increased microalbuminuria (> 20 mug/min) in 34% (22 of 65 subjects). Increased microalbuminuria and/or reduced creatinine clearance were detected in 48% of the subjects (31 of 65 subjects). Patients with microalbuminuria had greater diastolic blood pressure than those without microalbuminuria (mean, 98 +/- 4 versus 88 +/- 2 mm Hg; P = 0.02). in conclusion, after a mean of 2 years, patients with epidemic poststreptococcal GN caused by S zooepidemicus present a high rate of hypertension and frequent abnormalities of renal function, with some having reached end-stage renal disease. Longer follow-up will be important to define the prognosis of these patients. (C) 2001 by the National Kidney Foundation, Inc.
Keywords poststreptococcal glomerulonephritis (PSGN)
epidemic nephritis
acute nephritis
Streptococcus zooepidemicus
Language English
Date 2001-08-01
Published in American Journal of Kidney Diseases. Philadelphia: W B Saunders Co, v. 38, n. 2, p. 249-255, 2001.
ISSN 0272-6386 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co
Extent 249-255
Access rights Closed access
Type Article
Web of Science ID WOS:000170204700003

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