Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life.
OBJECTIVE
To test the hypothesis that post-streptococcal glomerulonephritis (PSGN) in childhood is a risk factor for chronic renal disease in later life.


METHODS
Retrospective cohort study.


METHODS
A remote Aboriginal community in the "Top End" of the Northern Territory that experienced two epidemics of PSGN in 1980 and 1987, respectively.


METHODS
472 people who were aged 2-15 years during either epidemic. They were categorised by clinical features recorded during the epidemics as having clinically defined PSGN (63), "abnormal urine" (haematuria or proteinuria; 86) or controls (323).


METHODS
Urinary albumin to creatinine ratio (ACR), haematuria (by dipstick urinalysis), blood pressure, serum creatinine level, and calculated glomerular filtration rate (GFR) during community screening in 1992-1998.


RESULTS
Overt albuminuria (ACR > 34 mg/mmol) was present at follow-up in 13% of the PSGN group, 8% of the abnormal urine group, and 4% of the control group. The odds ratio (OR) for overt albuminuria in those with a history of PSGN compared with the control group, adjusted for age and sex, was 6.1 (95% CI, 2.2-16.9). Haematuria (>trace) was present in 21% of the PSGN group compared with 7% of the control group (adjusted OR, 3.7; 95% CI, 1.8-8.0). There were no significant differences between the groups in blood pressure, serum creatinine level or calculated GFR.


CONCLUSIONS
In this population, a history of PSGN in childhood is a risk factor for albuminuria and haematuria in later life.
White
A V
AV
Menzies School of Health Research, Darwin, NT. Andrew.White@nt.gov.au
Hoy
W E
WE
McCredie
D A
DA
D000293:Adolescent; D000419:Albuminuria / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D006417:Hematuria / Q000208:ethnology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000209:etiology; D008297:Male; D015876:Northern Territory / Q000453:epidemiology; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017192:Skin Diseases, Bacterial / Q000150:complications / Q000208:ethnology; D013290:Streptococcal Infections / Q000150:complications / Q000208:ethnology*; D013297:Streptococcus pyogenes; D000095283:Australian Aboriginal and Torres Strait Islander Peoples