Clinicopathological profile and outcomes of infection-related glomerulonephritis in adults

Infection-related glomerulonephritis (IRGN) is an example of immune-mediated glomerular injury, with changing profile over the years. We analyzed the clinicopathological profile of IRGN from a single center.

Adult renal biopsies between July 2018 and January 2020 were screened, and biopsies with IRGN were included. The demographic, clinical, and laboratory data up to 6 months were analyzed.

27 patients were included, with 63% having evidence of current/recent infection, Staphylococcus and Streptococcus being most common (29.4%). The mean eGFR at presentation was 16.7 mL/min/1.73m², with crescents in 70.4% of cases. 59.3% required dialysis, and 40.7% received steroids. Complete recovery was seen in 84.6%, while 11.1% developed chronic kidney disease, and 3.7% progressed to end-stage renal disease. Persistent proteinuria, hematuria, and hypertension at 6 months were seen in 11.1, 7.4, and 3.7%, respectively. There was significant negative correlation between renal recovery and history of diabetes, interstitial fibrosis and tubular atrophy (IFTA), glomerulosclerosis, and IgA deposits. There was no significant impact of steroid use on outcome.

IRGN can have an aggressive course in adults, with renal recovery continuing beyond 3 months. IFTA, glomerulosclerosis, IgA deposits, and history of DM are significant negative predictors of clinical outcome, and there is no proven benefit of steroids.