April 2024, Volume 2, Issue 4

Author

T. Sugan Gandhi, Senthil Kumar Kasi, Shanmugasundaram Angusamy, Sowmiya Mohan, Sridatta Gurudatta Pawar and Ramudu Venkatraman

Abstract

Introduction: Infection-related glomerulonephritis, IRGN in adults is increasing in prevalence in India. However, there are only a few prospective studies from south India on the long term prognosis of this disease. Materials and Methods: This is a prospective observational study on patients above 18 years of age,with biopsy proven IRGN, at a tertiary care centre in south India with a minimum follow up of 6 months. Results: A total of 100 patients were included in the study. Peak incidence was in the age group of 40-60 years (n=45, 45%) with a male preponderance (n=56,56%). The most common co-morbidities were diabetes mellitus (n=27, 27%) and alcohol intake (n=13,13%). The most common source of infection was skin and soft tissues (n=41, 41%). Streptococcus and Staphylococcus were the most common isolated organisms. One patient had IRGN following SARS C0V-2 virus infection. Twenty three (n=23, 23%) required dialysis initiation. The mean follow up was 31.4 weeks. 3 patients died within 1 month of illness. At the end of 6 months, out of the 97 surviving patients, 34 (n=34,35%) patients had chronic kidney disease,CKD (eGFR <60 ml/per/1.73 m2) and 9 (n=9,9.27%) were dialysis dependant. Age >40 years, associated diabetes mellitus,underlying CKD, dialysis requiring renal failure at presentation,presence of crescentric GN and moderate to severe Interstitial Fibrosis and Tubular Atrophy in renal biopsy were identified as risk factors for development of CKD by univariate analysis. Conclusion: Adult IRGN is as an important cause of CKD and end stage renal disease in Indian adults especially in diabetics and those above 40 years of age.