Long-term follow-up of patients presenting to adult nephrologists with chronic pyelonephritis and 'normal' renal function.
We studied the natural history, and therefore prognosis, of patients with chronic pyelonephritis presenting to adult nephrologists with a plasma or serum creatinine <90 mmol/l. From the Newcastle chronic pyelonephritis database, 255 patients with radiologically-proven disease were reviewed. Median follow-up was 95 months (95%CI 82. 3-109.3). Plasma creatinine was < or =90 micromol/l (P(Cr)< or =90 group) at presentation in 138. At presentation, hypertension, bilateral disease and proteinuria were less frequent in the P(Cr)< or =90 group (hypertension 19% vs. 32%, p<0.05; bilateral disease 25% vs. 70%, p<0.001; proteinuria 18% vs. 60%, p<0.001). With the exception of two patients, the renal prognosis of this group was excellent. Patients over the age of 18 years presenting to adult nephrologists with a diagnosis of chronic pyelonephritis and a creatinine < or =90 micromol/l can be reassured that the chances of developing end-stage renal failure in the future are very small. Most could be referred back to their general practitioner for long-term follow-up.
Goodship
T H
TH
Department of Nephrology, School of Clinical Medical Sciences, and. Department of Radiology, University of Newcastle upon Tyne. t.h.j.goodship@ncl.ac.uk
Stoddart
J T
JT
Martinek
V
V
Geetha
D
D
Brown
A L
AL
Ward
M K
MK
Kerr
D N
DN
Owen
J P
JP
Wilkinson
R
R
D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011704:Pyelonephritis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
D003404:Creatinine