Ramanathan G

Abeyaratne A

Sundaram M

Fernandes, David

Pawar B

Perry GJ

Sajiv C

Majoni SW

2017-05-01

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. 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. 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 had multiple 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. On multivariable logistic regression analysis, those on dialysis had higher baseline creatinine (P = 0.003), higher albumin/creatinine ratio at presentation (P = 0.023), higher serum creatinine at presentation (P = 0.02) and lower estimated glomerular filtration rate at presentation (P = 0.012). Overall, most patients had pre-existing pathology with superimposed acute postinfectious glomerulonephritis that led to poor outcomes in our cohort.

Nephrology (Carlton, Vic.) 2017-05; 22(5): 403-411

https://pubmed.ncbi.nlm.nih.gov/27062647/?otool=iaurydwlib

https://hdl.handle.net/10137/5360

Aborigines

Australia

end-stage renal failure

glomerulonephritis

infection

Acute Disease

Adult

Biopsy

Communicable Diseases

Comorbidity

Disease Progression

Female

Fluorescent Antibody Technique

Glomerulonephritis

Humans

Kidney

Kidney Failure, Chronic

Male

Microscopy, Electron

Middle Aged

Northern Territory

Renal Dialysis

Retrospective Studies

Risk Factors

Time Factors

Treatment Outcome

Oceanic Ancestry Group

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.

Journal Article

Publication