Poststreptococcal Glomerulonephritis

Dodge, Warren F.; Spargo, Benjamin H.; Travis, Luther B.; Srivastava, R. N.; Carvajal, Hugo F.; DeBeukelaer, Martin M.; Longley, Michael P.; Menchaca, John A.

doi:10.1056/nejm197202102860601

Cited by 85 publications

(3 citation statements)

References 18 publications

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“…Even in group A cases short-term prognosis of GN is undoubtedly good [ 4 ], but long-term prognosis is controversial. In general it is considered good in epidemic cases [ 11 , 14 ] and in children [ 18 ], and less favorable in medium- to long-term in adults with sporadic GN [ 12 , 16 , 19 , 20 ]. Recent studies demonstrate that sporadic PSGN are still a health problem in several regions of the world [ 21 – 23 ].…”

Section: Discussionmentioning

confidence: 99%

Ten-Year Follow-up of Patients with Epidemic Post Infectious Glomerulonephritis

Pinto¹,

Kirsztajn

Sesso

2015

PLoS ONE

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BackgroundScarce information on outcomes of epidemic post infectious glomerulonephritis is available. This is a 10-year follow-up of the patients that developed acute glomerulonephritis in an epidemic outbreak caused by group C Streptococcus zooepidemicus in Brazil in 1998, that were also previously evaluated 2 and 5 years after the acute episode.MethodsIn this prospective study 60 cases (out of 134 in 1998) were reevaluated after 10 years, as well as community controls matched by gender and age. They underwent clinical and renal function evaluation, including serum creatinine and cystatin C, estimated glomerular filtration rate (eGFR), albuminuria and hematuria.ResultsComparisons of clinical and renal function aspects of 60 patients and 48 community controls have not shown significant differences (eGFR <60 ml/min/1.73m2 and/or albuminuria >30mg/g creatinine: 13.8% vs. 12.2%, respectively, p = 0.817) except for a higher frequency of hypertension in the cases (45.0% vs. 20.8%, p = 0.009). Comparing the same patients affected in the acute episode, 2, 5 and 10 years later, it was observed an improvement of median eGFR levels at 2 years and a trend toward subsequent stabilization in these levels, associated with decrease in albuminuria and increased hypertension rates in the last survey. At 10 years it was not observed additional reduction of renal function using serum creatinine, eGFR and cystatin C.ConclusionsDuring the acute episode of epidemic GN a considerable proportion of patients presented hypertension and reduced renal function; after 2 years and particularly at this 10-year follow-up survey there was no worsening of renal function parameters, except for persistent higher frequency of hypertension. Nevertheless, a longer follow up is necessary to confirm that progressive loss of renal function will not occur.

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Section: Discussionmentioning

confidence: 99%

Ten-Year Follow-up of Patients with Epidemic Post Infectious Glomerulonephritis

Pinto¹,

Kirsztajn

Sesso

2015

PLoS ONE

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“…Adult nephrologists pointed to unfavorable outcome (11,12) while pediatricians had more optimistic view (4,(13)(14)(15)(16). The long-term prognosis of PSGN is a matter of debate.…”

Section: Discussionmentioning

confidence: 99%

“…Excretion of urinary proteins (UP) is an important marker for evaluating patients with progres-sive renal disease (1)(2)(3). We were particularly interested if we could detect orthostatic proteinuria in postnephritic children, since it is believed that overt proteinuria becomes orthostatic before it finally clears (4). In patients with chronic nephropathies proteinuria is persistent, but the amount of excreted proteins may increase after orthostasis or heavy exercise.…”

Section: Introductionmentioning

confidence: 99%

Stress Tolerance Test and SDS-PAGE for the Analysis of Urinary Proteins in Children and Youths

Tasić

Korneti²,

Gucev³

et al. 2001

Clinical Chemistry and Laboratory Medicine

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Excretion of urinary proteins (UP) is an important marker for the evaluation of patients with progressive renal disease. In order to analyze quantitative and qualitative variability of UP in relation to physical activity, we used standardized stress tolerance test and SDS-PAGE. Five urine samples were obtained from each patient at rest, during ordinary daily activity and after physical stress. Determination of total proteins was performed using Meulman's classic method with sulfosalicylic acid. UP were separated by ultrathin horizontal gradient SDS-PAGE according to Görg. There were 142 patients; 40 with poststreptococcal glomerulonephritis (PSGN), 11 with diabetes mellitus, 16 with chronic pyelonephritis and 75 who attended for investigation of asymptomatic proteinuria. Functional proteinuria was established in 42 subjects, who displayed maximal UP excretion during stress and the presence of apolipoprotein AI on SDS-PAGE. Children with PSGN showed no significant increase of UP during stress. Some children with diabetes mellitus (27%) and chronic pyelonephritis (47%) displayed microproteinuria or overt proteinuria after stress. Quantitative and qualitative changes in total UP excretion can be detected by stress tolerance test and SDS-PAGE. It remains to be seen whether stress tolerance test can identify children and youths who are at higher risk for disease progression.

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Cost Effectiveness of Renal Disease Screening

Dodge¹

1977

Arch Pediatr Adolesc Med

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Poststreptococcal Glomerulonephritis

Cited by 85 publications

References 18 publications

Ten-Year Follow-up of Patients with Epidemic Post Infectious Glomerulonephritis

Ten-Year Follow-up of Patients with Epidemic Post Infectious Glomerulonephritis

Stress Tolerance Test and SDS-PAGE for the Analysis of Urinary Proteins in Children and Youths

Cost Effectiveness of Renal Disease Screening

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