[Kidney involvement in infectious endocarditis (hematuria)]

As many as 113 patients suffering from infectious endocarditis (IE) were placed under observation. Renal damage was discovered in 28 patients (24.7%). Hematuria was the common laboratory sign of renal damage. 15% of patients showed microhematuria, 9.7 had macrohematuria. In 15% of patients with IE, hematuria was due to diffuse glomerulonephritis, in 5.3% to renal infarction, and in 4.4% to focal glomerulonephritis. In 3.5% of patients, the nephrotic syndrome developed at the disease onset, it was attended by hematuria and was thus a cause of erroneous diagnoses. The appearance of hematuria at the IE onset, attesting to involvement of the kidneys into the pathological process, complicates the diagnosis and early treatment institution. Detection of the hematuric syndrome in patients with a verified diagnosis of IE requires specification of the character of renal damage. The latter one contributes to a graver and prognostically unfavourable course of IE. In 2 out of 8 patients with associated IE and renal damage, the death was caused by progressive chronic renal failure. Postmortem examination confirmed mesangioproliferative glomerulonephritis in all the subjects; in 4, it was coupled with renal infarction. 14.1% of the patients manifested complete and 3.5% partial disappearance of hematuria under the influence of adequate antibacterial therapy of IE.