Bibliographic Details
| Title: |
Analysis of clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in adult indigenous people of the Northern Territory of Australia. |
| Authors: |
Ramanathan, Ganesh1,2 ganesh_sgi@hotmail.com, Abeyaratne, Asanga1, Sundaram, Madhivanan1, Fernandes, David Kiran2, Pawar, Basant2, Perry, Greg John3,4, Sajiv, Cherian2,5, Majoni, Sandawana William1,5 |
| Source: |
Nephrology. May2017, Vol. 22 Issue 5, p403-411. 9p. |
| Subject Terms: |
*GLOMERULONEPHRITIS, *CHRONIC kidney failure, *BIOPSY, *DIABETES, *HYPERTENSION |
| Abstract: |
Aim: Acute postinfectious glomerulonephritis is common in indigenous communities in the Northern Territory, Australia. It is a major risk factor for the high prevalence of chronic kidney disease. We aimed to analyse the clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in the Northern Territory. Methods: We performed a retrospective cohort analysis of all adult patients (=18 years) who were diagnosed with acute postinfectious glomerulonephritis on native renal biopsies from 01/01/2004 to 31/05/2014. The outcome measure was end-stage renal disease requiring long-term dialysis. Results: Forty-three of 340 patients who had renal biopsies had acute postinfectious glomerulonephritis. Most were Aboriginals (88.4%). They had co-morbidities; diabetes mellitus (60.5%), hypertension (60.5%) and smoking (56.4%). Forty-nine per cent hadmultiple pathologies on biopsy. Predominant histological pattern was diffuse proliferative glomerulonephritis (72%). Main sites of infections were skin (47.6%) and upper respiratory tract infection (26.2%) with streptococcus and staphylococcus as predominant organisms. Fifty per cent of patients developed end-stage renal disease. Onmultivariable logistic regression analysis, those on dialysis had higher baseline creatinine (P = 0.003), higher albumin/creatinine ratio at presentation (P = 0.023), higher serumcreatinine at presentation (P = 0.02) and lower estimated glomerular filtration rate at presentation (P = 0.012). Conclusion: Overall, most patients had pre-existing pathology with superimposed acute postinfectious glomerulonephritis that led to poor outcomes in our cohort. [ABSTRACT FROM AUTHOR] |
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