Infection-Related Glomerulonephritis: Clinicopathological Profile And Outcomes From A Tertiary Care Centre In South India

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Dr. Permi Vamshi Dharan, Dr. Raghukanth Reddy G, Dr. Manjunath S Shetty, Dr. Kiran K.K, Dr. Manoj C, Dr. Sourabha R

Abstract

Introduction


Infection-related glomerulonephritis (IRGN) is an immunological renal damage resulting from current or recent infections. As the landscape of IRGN has evolved, renal biopsy has become crucial for diagnosing and distinguishing this condition from others, as well as for predicting long-term consequences. The aim of present study is to assess the clinicopathological profile and outcomes of infection related glomerulonephritis in South India from a tertiary care center.


 


Material and methods


This retrospective study collected data of 73 patients diagnosed with IGRN with mean follow-up of 1 year. Demographic, clinical, laboratory, histological parameters and outcomes observed were assessed.


 


Results


The mean age of patients was 44.1±17.6 years. Number of female patients were 30.1% and male patients were 69.9%. 78.1% had low complement level C3. 56.20% had acute GN while 17.8% had RPGN presentation. The most common site of infection was skin and soft tissue (32.90%). The most common organism found in the culture was klebsiella pneumonia (4.1%). The mean creatinine at presentation was 3.10 ± 2.5 mg/dl, with an estimated glomerular filtration rate (eGFR) of 47.26 ± 39.82 ml/min/1.73 m² and an average proteinuria of 3.14 ± 1.4 gm/24h. 100% of the samples showed an endocapillary proliferative pattern, 97.9% showed a mesangial proliferative pattern, and 6.1% showed MPGN pattern. 80.8% had an exudative neutrophilic infiltration. C3 was the universal immunological reactant with IgG being the most common immunoglobulin (69.4%) and IgM being the least common (4.1%), 10% of biopsies had IgA codominant pattern and in 4% biopsies full house pattern was seen. 75.3% recovered completely, in 54.8% hypertension persisted for more than 6 months and persistent proteinuria was seen in 27.4 % patients. 27.3% progressed to CKD while 10.9% remained dialysis dependent at the end of 1 year. Age >40 years (p=0.001), alcohol intake (p=0.001), peak creatinine >1.5 mg/dl (p=0.001) and RRT required (p-0.001) were associated with failure to attain complete recovery and were identified as independent risk factors in our study.


 


Conclusion


IRGN is a common clinical entity in adults with the potential for adverse renal and survival outcomes

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