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The spectrum of adult postinfectious glomerulonephritis in the new millennium.
MedLine Citation:
PMID:  19814634     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Postinfectious glomerulonephritis is rare in adults. The characteristics of the disease now differ from what were described decades ago. The goal of this study is to illustrate the clinicopathological spectrum of the disease in the modern era. METHODS: Between July 2000 and June 2008, 20 adult cases of postinfectious glomerulonephritis were identified at a medical center in Taiwan. The patients' records were retrospectively reviewed with respect to clinical presentation, microbiology, serology, morphology of renal biopsy, and clinical course. RESULTS: There were 14 males and 6 females. The mean age was 61 years. All patients developed acute renal failure, and the majority (65%) required dialysis support during the disease course. Hypocomplementemia was present in 60% of patients. The most frequently identified infectious agent was Staphylococcus (60%). Histological characteristics showed two distinct patterns of glomerulonephritis: diffuse endocapillary proliferative glomerulonephritis (65%) and focal mesangial proliferative glomerulonephritis (35%). There were no significant differences in the clinical presentation and outcome between the two groups. However, glomerular neutrophil infiltration was more commonly present in diffuse endocapillary proliferative pattern (p = 0.017). The percentage of patients with focal mesangial proliferative pattern significantly increased over time (p < 0.001). At the last follow-up, 6 patients (30%) had died, 6 (30%) were in complete remission, 4 (20%) had partial remission with renal insufficiency, and 4 (20%) were on chronic dialysis. CONCLUSIONS: Our data suggested that Staphylococcus had become the leading pathogen in adult postinfectious glomerulonephritis over the past 10 years. Furthermore, atypical histological feature with focal mesangial proliferative pattern was increasingly identified over time. The prognosis was still guarded, carrying a considerable mortality rate and risk for developing chronic renal failure.
Yao-Ko Wen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Renal failure     Volume:  31     ISSN:  1525-6049     ISO Abbreviation:  Ren Fail     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-09     Completed Date:  2010-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  England    
Other Details:
Languages:  eng     Pagination:  676-82     Citation Subset:  IM    
Division of Nephrology, Changhua Christian Medical Center, Changhua, Taiwan.
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MeSH Terms
Aged, 80 and over
Glomerulonephritis / classification*,  etiology,  microbiology*,  pathology
Kidney Failure, Acute / etiology,  therapy
Middle Aged
Renal Dialysis
Staphylococcal Infections / complications*

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