NDT Advance Access originally published online on May 26, 2005
Nephrology Dialysis Transplantation 2005 20(9):1808-1812; doi:10.1093/ndt/gfh904
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Five-year follow-up of patients with epidemic glomerulonephritis due to Streptococcus zooepidemicus
1 Division of Nephrology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil and 2 Division of Nephrology, Hospital São João de Deus, Divinópolis, Brazil
Correspondence and offprint requests to: Ricardo Sesso, Division of Nephrology, Escola Paulista de Medicina, Unifesp, Rua Botucatu 740, São Paulo, SP, Brazil, 04023-900. Email: rsesso{at}nefro.epm.br
Background. In 1998 there was a large outbreak of acute glomerulonephritis in Nova Serrana, Brazil, caused by group C Streptococcus zooepidemicus. This study describes the follow-up of these patients, after a mean time of 5.4 years of the acute episode.
Methods. Of 135 cases identified in 1998, 56 were re-examined in a prospective study and had measurements of blood pressure, creatinine clearance (estimated by the Cockcroft and Gault formula), microalbuminuria (radioimmunoassay), urine sediment analysis and a protein dipstick test.
Results. Of the original group of 135 subjects, 3 died in the acute phase and 5 (3.7%) required chronic dialysis. Of the 56 cases re-evaluated, 54 (96%) were adults (mean±SD age, 43±17 years) and 36 (64%) females. At the follow-up examination, we found arterial hypertension in 30% (n = 17/56) of the subjects, reduced creatinine clearance (<80 ml/min) in 49% (n = 26/53) and increased microalbuminuria (>20 µg/min) in 22% (n = 11/51). Compared to the evaluation carried out 3 years before, the number of cases with creatinine clearance lower than 80 ml/min increased from 20 to 26 (of 53 cases). Increased microalbuminuria and/or reduced creatinine clearance were detected in 57% (n = 32/56) of the subjects. Patients with reduced creatinine clearance were older than those without reduced renal function (54±15 vs 34±12 years, P<0.001).
Conclusions. After a mean time of 5.4 years, a relatively high proportion of patients with epidemic poststreptococcal glomerulonephritis due to S.zooepidemicus present hypertension, reduced renal function and increased microalbuminuria.
Keywords: acute nephritis; epidemic nephritis; follow-up; poststreptococcal glomerulonephritis; Streptococcus zooepidemicus
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  B. Rodriguez-Iturbe and J. M. Musser The Current State of Poststreptococcal Glomerulonephritis J. Am. Soc. Nephrol., October 1, 2008; 19(10): 1855 - 1864. [Abstract] [Full Text] [PDF]
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