Acute post-streptococcal glomerulonephritis in adults: a long-term study.

Area of Science:

• Nephrology
• Pediatric Nephrology
• Immunology

Background:

• Acute post-streptococcal glomerulonephritis (PSGN) is an immune-mediated kidney disease.
• It typically presents with hypertension, hematuria, and proteinuria.

Purpose of the Study:

• To assess the long-term prognosis and renal outcome in patients with acute PSGN.
• To evaluate the rate of histological resolution of kidney lesions post-PSGN.

Main Methods:

• A cohort of 57 patients with confirmed acute PSGN was followed for 1-14 years (mean 7 years).
• Clinical data (hypertension, hematuria, proteinuria, renal function) and serological markers (ASO titre, complement levels) were recorded.
• Follow-up renal biopsies were performed in 33 patients, with 18 undergoing biopsy five or more years after the initial illness.

Main Results:

• The majority of patients demonstrated a good long-term prognosis.
• Five patients died after two years, with only two showing abnormal renal function at death.
• Eleven patients had persistent proteinuria, hematuria, or abnormal renal function; repeat biopsies showed normal histology in 3, incomplete resolution in 5, and obsolescent glomeruli in 1.
• No patient with normal renal function at follow-up had abnormal renal histology.

Conclusions:

• Acute PSGN generally carries a favorable long-term outcome.
• Complete histological resolution of renal lesions can be delayed, potentially taking up to nine years.
• Close monitoring is essential, as some patients may exhibit incomplete resolution or develop mild hypertension.