Analysis of clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in adult indigenous people of the Northern Territory of Australia

Ganesh Ramanathan, Asanga Abeyaratne, Madhivanan Sundaram, David Kiran Fernandes, Basant Pawar, Gregory Perry, Cherian Sajiv, Sandawana William Majoni

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    Aim: Acute postinfectious glomerulonephritis is common in indigenous communities in the Northern Territory, Australia. It is a major risk factor for the high prevalence of chronic kidney disease. We aimed to analyse the clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in the Northern Territory. Methods: We performed a retrospective cohort analysis of all adult patients (≥18 years) who were diagnosed with acute postinfectious glomerulonephritis on native renal biopsies from 01/01/2004 to 31/05/2014. The outcome measure was end-stage renal disease requiring long-term dialysis. Results: Forty-three of 340 patients who had renal biopsies had acute postinfectious glomerulonephritis. Most were Aboriginals (88.4%). They had co-morbidities; diabetes mellitus (60.5%), hypertension (60.5%) and smoking (56.4%). Forty-nine per cent had multiple pathologies on biopsy. Predominant histological pattern was diffuse proliferative glomerulonephritis (72%). Main sites of infections were skin (47.6%) and upper respiratory tract infection (26.2%) with streptococcus and staphylococcus as predominant organisms. Fifty per cent of patients developed end-stage renal disease. On multivariable logistic regression analysis, those on dialysis had higher baseline creatinine (P = 0.003), higher albumin/creatinine ratio at presentation (P = 0.023), higher serum creatinine at presentation (P = 0.02) and lower estimated glomerular filtration rate at presentation (P = 0.012). Conclusion: Overall, most patients had pre-existing pathology with superimposed acute postinfectious glomerulonephritis that led to poor outcomes in our cohort. © Asian Pacific Society of Nephrology

    Original languageEnglish
    Pages (from-to)403-411
    Number of pages9
    JournalNephrology
    Volume22
    Issue number5
    DOIs
    Publication statusPublished - 1 May 2017

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    Northern Territory
    Glomerulonephritis
    Biopsy
    Creatinine
    Chronic Kidney Failure
    Dialysis
    Pathology
    Kidney
    Nephrology
    Streptococcus
    Glomerular Filtration Rate
    Chronic Renal Insufficiency
    Staphylococcus
    Respiratory Tract Infections
    Albumins
    Diabetes Mellitus
    Cohort Studies
    Logistic Models
    Smoking
    Regression Analysis

    Cite this

    Ramanathan, Ganesh ; Abeyaratne, Asanga ; Sundaram, Madhivanan ; Fernandes, David Kiran ; Pawar, Basant ; Perry, Gregory ; Sajiv, Cherian ; Majoni, Sandawana William. / Analysis of clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in adult indigenous people of the Northern Territory of Australia. In: Nephrology. 2017 ; Vol. 22, No. 5. pp. 403-411.
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    title = "Analysis of clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in adult indigenous people of the Northern Territory of Australia",
    abstract = "Aim: Acute postinfectious glomerulonephritis is common in indigenous communities in the Northern Territory, Australia. It is a major risk factor for the high prevalence of chronic kidney disease. We aimed to analyse the clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in the Northern Territory. Methods: We performed a retrospective cohort analysis of all adult patients (≥18 years) who were diagnosed with acute postinfectious glomerulonephritis on native renal biopsies from 01/01/2004 to 31/05/2014. The outcome measure was end-stage renal disease requiring long-term dialysis. Results: Forty-three of 340 patients who had renal biopsies had acute postinfectious glomerulonephritis. Most were Aboriginals (88.4{\%}). They had co-morbidities; diabetes mellitus (60.5{\%}), hypertension (60.5{\%}) and smoking (56.4{\%}). Forty-nine per cent had multiple pathologies on biopsy. Predominant histological pattern was diffuse proliferative glomerulonephritis (72{\%}). Main sites of infections were skin (47.6{\%}) and upper respiratory tract infection (26.2{\%}) with streptococcus and staphylococcus as predominant organisms. Fifty per cent of patients developed end-stage renal disease. On multivariable logistic regression analysis, those on dialysis had higher baseline creatinine (P = 0.003), higher albumin/creatinine ratio at presentation (P = 0.023), higher serum creatinine at presentation (P = 0.02) and lower estimated glomerular filtration rate at presentation (P = 0.012). Conclusion: Overall, most patients had pre-existing pathology with superimposed acute postinfectious glomerulonephritis that led to poor outcomes in our cohort. {\circledC} Asian Pacific Society of Nephrology",
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    author = "Ganesh Ramanathan and Asanga Abeyaratne and Madhivanan Sundaram and Fernandes, {David Kiran} and Basant Pawar and Gregory Perry and Cherian Sajiv and Majoni, {Sandawana William}",
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    Analysis of clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in adult indigenous people of the Northern Territory of Australia. / Ramanathan, Ganesh; Abeyaratne, Asanga; Sundaram, Madhivanan; Fernandes, David Kiran; Pawar, Basant; Perry, Gregory; Sajiv, Cherian; Majoni, Sandawana William.

    In: Nephrology, Vol. 22, No. 5, 01.05.2017, p. 403-411.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Analysis of clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in adult indigenous people of the Northern Territory of Australia

    AU - Ramanathan, Ganesh

    AU - Abeyaratne, Asanga

    AU - Sundaram, Madhivanan

    AU - Fernandes, David Kiran

    AU - Pawar, Basant

    AU - Perry, Gregory

    AU - Sajiv, Cherian

    AU - Majoni, Sandawana William

    PY - 2017/5/1

    Y1 - 2017/5/1

    N2 - Aim: Acute postinfectious glomerulonephritis is common in indigenous communities in the Northern Territory, Australia. It is a major risk factor for the high prevalence of chronic kidney disease. We aimed to analyse the clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in the Northern Territory. Methods: We performed a retrospective cohort analysis of all adult patients (≥18 years) who were diagnosed with acute postinfectious glomerulonephritis on native renal biopsies from 01/01/2004 to 31/05/2014. The outcome measure was end-stage renal disease requiring long-term dialysis. Results: Forty-three of 340 patients who had renal biopsies had acute postinfectious glomerulonephritis. Most were Aboriginals (88.4%). They had co-morbidities; diabetes mellitus (60.5%), hypertension (60.5%) and smoking (56.4%). Forty-nine per cent had multiple pathologies on biopsy. Predominant histological pattern was diffuse proliferative glomerulonephritis (72%). Main sites of infections were skin (47.6%) and upper respiratory tract infection (26.2%) with streptococcus and staphylococcus as predominant organisms. Fifty per cent of patients developed end-stage renal disease. On multivariable logistic regression analysis, those on dialysis had higher baseline creatinine (P = 0.003), higher albumin/creatinine ratio at presentation (P = 0.023), higher serum creatinine at presentation (P = 0.02) and lower estimated glomerular filtration rate at presentation (P = 0.012). Conclusion: Overall, most patients had pre-existing pathology with superimposed acute postinfectious glomerulonephritis that led to poor outcomes in our cohort. © Asian Pacific Society of Nephrology

    AB - Aim: Acute postinfectious glomerulonephritis is common in indigenous communities in the Northern Territory, Australia. It is a major risk factor for the high prevalence of chronic kidney disease. We aimed to analyse the clinical presentation, pathological spectra, treatment and outcomes of biopsy-proven acute postinfectious glomerulonephritis in the Northern Territory. Methods: We performed a retrospective cohort analysis of all adult patients (≥18 years) who were diagnosed with acute postinfectious glomerulonephritis on native renal biopsies from 01/01/2004 to 31/05/2014. The outcome measure was end-stage renal disease requiring long-term dialysis. Results: Forty-three of 340 patients who had renal biopsies had acute postinfectious glomerulonephritis. Most were Aboriginals (88.4%). They had co-morbidities; diabetes mellitus (60.5%), hypertension (60.5%) and smoking (56.4%). Forty-nine per cent had multiple pathologies on biopsy. Predominant histological pattern was diffuse proliferative glomerulonephritis (72%). Main sites of infections were skin (47.6%) and upper respiratory tract infection (26.2%) with streptococcus and staphylococcus as predominant organisms. Fifty per cent of patients developed end-stage renal disease. On multivariable logistic regression analysis, those on dialysis had higher baseline creatinine (P = 0.003), higher albumin/creatinine ratio at presentation (P = 0.023), higher serum creatinine at presentation (P = 0.02) and lower estimated glomerular filtration rate at presentation (P = 0.012). Conclusion: Overall, most patients had pre-existing pathology with superimposed acute postinfectious glomerulonephritis that led to poor outcomes in our cohort. © Asian Pacific Society of Nephrology

    KW - Aborigines

    KW - Australia

    KW - end-stage renal failure

    KW - glomerulonephritis

    KW - infection

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    M3 - Article

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