Abstract: SA-PO631
Infection-Related Glomerulonephritis and Analysis of Clinical Outcomes: Experience in South India
Session Information
- Glomerular Diseases: ANCA, Anti-GBM, Kidney Biopsy
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Author
- Raju, Sree Bhushan, Shiloh House, Hyderabad, Telangana, India
Background
There has been a major shift in the causative agents, clinical presentation, epidemiology and the treatment outcomes of IRGN in the developing nations.
Methods
A retrospective analysis of 100 IRGN consecutive cases were studied from our hospital records. percutaneous renal biopsy was done in all the patients and the tissue has been processed for LM IF and EM after appropriate staining for clinical and pathological characteristics
Results
A retrospective analysis of 100 IRGN consecutive cases were studied from our hospital records. percutaneous renal biopsy was done in all the patients and the tissue has been processed for light microscopy, immunofluorescence and electron microscopy after appropriate staining for clinical and pathological characteristics
Results: A total of 73 patients were analyzed after exclusion. The mean age of the presentation was 41.89±14.58 years. 51% were males. Common infection sources were UTI (33%) and foot ulcer (33%). Most common clinical presentations were shortness of breath (45%), Anasarca (38%) and fever (36%). All the patients had micro hematuria (100%). The mean creatinine at presentation was 3.37± 2.47 mg/dl with an average proteinuria of 2.43 ± 1.28 g/24hr. 94% had low C3, 8% had low C4,8 % had low C3+C4.55% c4d negative out of c4d negative ,38% are c3 codominant and 63% are c3 dominant. Mean serum creatinine at presentation 4.1±2.6 and 3.3±2.5 (p value:0.8). Proteinuria between two groups was statistically significant.On light microscopy, the most common histological pattern of injury is endocapillary proliferation with neutrophil in mesangial tufts. Immunofluoresence pattern revealed immunoglobulin and C3 dominant staining commonly. Mean GBM thickness was seen in 358.95±99.2. Diffuse effacement was seen in 13 patients, focal effacement was seen in 27 patients. 23% patients needed hemodialysis and 8% needed plasmapheresis at presentation. 20% patients needed immunosuppression. At the end of 12months, 35% patients had persistent hypertension and 30% patients had persistent renal dysfunction. Persistent proteinuria was noted in 17 % of patients and persistent hematuria was seen in 30 % of patients at 1 year follow up. Spot PCR and creatinine between C4d negative C3 dominant and codominant groups was not significant at 1 year .
Conclusion
Male sex, age>40 years, creatinine>5 mg/dl, dialysis requirement at presentation were independently associated with poor renal outcomes.