Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11011
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.
Authors: Ramanathan, Ganesh
Abeyaratne, Asanga
Sundaram, Madhivanan
Fernandes, David Kiran
Pawar, Basant
Perry, Greg John
Sajiv, Cherian
Majoni, Sandawana William
Affiliation: Department of Nephrology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.. Department of Nephrology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..
Department of Nephrology, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Department of Nephrology, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Department of Nephrology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..
Department of Nephrology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..
Department of Nephrology, Royal Perth Hospital, Perth, Western Australia, Australia.. School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia..
Department of Nephrology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.. Northern Territory Medical Programme, School of Medicine, Flinders University, Darwin, Northern Territory, Australia..
Department of Nephrology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.. Northern Territory Medical Programme, School of Medicine, Flinders University, Darwin, Northern Territory, Australia..
Issue Date: May-2017
Citation: Nephrology (Carlton, Vic.) 2017-05; 22(5): 403-411
Abstract: 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. 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. 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). Overall, most patients had pre-existing pathology with superimposed acute postinfectious glomerulonephritis that led to poor outcomes in our cohort.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11011
DOI: 10.1111/nep.12797
Type: Journal Article
Multicenter Study
Subjects: Aborigines
Australia
end-stage renal failure
glomerulonephritis
infection
Acute Disease
Adult
Biopsy
Communicable Diseases
Comorbidity
Disease Progression
Female
Fluorescent Antibody Technique
Glomerulonephritis
Humans
Kidney
Kidney Failure, Chronic
Male
Microscopy, Electron
Middle Aged
Northern Territory
Renal Dialysis
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Oceanic Ancestry Group
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