Post-streptococcal glomerulonephritis is a strong risk factor for chronic kidney disease in later life

Hoy, Wendy E., White, Andrew V., Dowling, Alison, Sharma, Suresh K., Bloomfield, Hilary, Tipiloura, Bernard T., Swanson, Cheryl E., Mathews, John D., and McCredie, David A. (2012) Post-streptococcal glomerulonephritis is a strong risk factor for chronic kidney disease in later life. Kidney International, 81 (10). pp. 1026-1032.

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Abstract

Although unusual in western countries and in Australia in general, post-streptococcal glomerulonephritis (PSGN) is still common in Australian Aboriginal children living in remote communities. Here, we evaluated whether episodes of acute PSGN increased the risk for chronic kidney disease in later life in 1519 residents of a remote Aboriginal community (85% of those age eligible), with high rates of renal and cardiovascular disease, who participated in a health screen over a 3-year period. Of these, 200 had had at least one episode of PSGN, with 27 having had multiple episodes, usually in childhood. High levels of albuminuria (albumin/creatinine ratio) with increasing age were confirmed. All PSGN episodes were associated with group A streptococcal skin infections, often related to scabies. In both genders, aged 10–39 years at screening, about one in five had such a history. Among them, PSGN (5 years or more earlier) was significantly associated with higher levels of albuminuria than those without. In women, aged 30–39 years, a history of PSGN was associated with a significantly higher frequency of estimated glomerular filtration rates <60 ml/min. The adjusted odds ratios for an albumin/creatinine ratio over 34 g/mol (overt albuminuria) in males and females with a history of PSGN were 4.6 and 3.1, respectively, compared with those without a history. Thus, PSGN contributes to the very serious burden of chronic kidney disease in this community. Rigorous strategies to prevent scabies and Group A streptococcal infections will reduce this burden.

Item ID: 21969
Item Type: Article (Refereed Research - C1)
Keywords: albuminuria, chronic kidney disease, post streptococcal glomerulonephritis
ISSN: 1523-1755
Date Deposited: 07 Jun 2012 01:52
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110312 Nephrology and Urology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920119 Urogenital System and Disorders @ 50%
92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 50%
Citation Count from Web of Science Web of Science 2
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