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Childhood post‐streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life

2001; Wiley; Volume: 174; Issue: 10 Linguagem: Inglês

10.5694/j.1326-5377.2001.tb143394.x

1326-5377

Andrew V White, Wendy E. Hoy, David A. McCredie,

Diabetes and associated disorders

Objective To test the hypothesis that post-streptococcal glomerulonephritis (PSGN) in childhood is a risk factor for chronic renal disease in later life. Design Retrospective cohort study. Setting A remote Aboriginal community in the "Top End" of the Northern Territory that experienced two epidemics of PSGN in 1980 and 1987, respectively. Participants 472 people who were aged 2–15 years during either epidemic. They were categorised by clinical features recorded during the epidemics as having clinically defined PSGN (63), "abnormal urine" (haematuria or proteinuria; 86) or controls (323). Outcome measures Urinary albumin to creatinine ratio (ACR), haematuria (by dipstick urinalysis), blood pressure, serum creatinine level, and calculated glomerular filtration rate (GFR) during community screening in 1992–1998. Results Overt albuminuria (ACR > 34 mg/mmol) was present at follow-up in 13% of the PSGN group, 8% of the abnormal urine group, and 4% of the control group. The odds ratio (OR) for overt albuminuria in those with a history of PSGN compared with the control group, adjusted for age and sex, was 6.1 (95% CI, 2.2–16.9). Haematuria (> trace) was present in 21% of the PSGN group compared with 7% of the control group (adjusted OR, 3.7; 95% CI, 1.8–8.0). There were no significant differences between the groups in blood pressure, serum creatinine level or calculated GFR. Conclusion In this population, a history of PSGN in childhood is a risk factor for albuminuria and haematuria in later life.