Overrepresentation of blood group non-secretors in adults with renal scarring

Host factors are important in the pathogenesis of pyelonephritic renal scarring. The present study used blood group secretor state as a population marker to determine if patients developing renal scarring are a selected subgroup of individuals with urinary tract infections (UTI). Non-secretors represented 15/43 (35%) of the patients with renal scarring but only 7/41 (17%) of the patients without renal scarring (p = 0.059 and NS respectively vs. healthy controls 22%). The frequency of non-secretors among P1 phenotype patients with renal scarring was 38% (p = 0.05 vs. healthy controls). Among the patients born after the introduction of regular use of antibiotic treatment for UTI the frequency of non-secretors was 55% in the scarred group compared to 13% in the unscarred group (p = 0.011). Thus, in this younger group of patients with renal scarring 6/10 (60%) of the non-secretors developed renal scars compared to 5/32 (16%) of the secretors (p less than 0.05). Our data confirm that blood group non-secretors are overrepresented in patients with non obstructive renal scarring suggesting that blood group non-secretor state might be a host marker to consider for the subgroup of individuals with recurrent UTI at risk to develop renal scars. Renal function was not influenced by blood group secretor state. The mean glomerular filtration rate within the scarred group was similar for secretors and non-secretors (80 ml/min X 1.73 m2 and 79 ml/min X 1.73 m2, respectively). Whether blood group secretor state also is involved in the scarring process remains to be investigated.