Five-year follow-up of patients with epidemic glomerulonephritis due to Streptococcus zooepidemicus.
BACKGROUND
In 1998 there was a large outbreak of acute glomerulonephritis in Nova Serrana, Brazil, caused by group C Streptococcus zooepidemicus. This study describes the follow-up of these patients, after a mean time of 5.4 years of the acute episode.


METHODS
Of 135 cases identified in 1998, 56 were re-examined in a prospective study and had measurements of blood pressure, creatinine clearance (estimated by the Cockcroft and Gault formula), microalbuminuria (radioimmunoassay), urine sediment analysis and a protein dipstick test.


RESULTS
Of the original group of 135 subjects, 3 died in the acute phase and 5 (3.7%) required chronic dialysis. Of the 56 cases re-evaluated, 54 (96%) were adults (mean+/-SD age, 43+/-17 years) and 36 (64%) females. At the follow-up examination, we found arterial hypertension in 30% (n = 17/56) of the subjects, reduced creatinine clearance (<80 ml/min) in 49% (n = 26/53) and increased microalbuminuria (>20 microg/min) in 22% (n = 11/51). Compared to the evaluation carried out 3 years before, the number of cases with creatinine clearance lower than 80 ml/min increased from 20 to 26 (of 53 cases). Increased microalbuminuria and/or reduced creatinine clearance were detected in 57% (n = 32/56) of the subjects. Patients with reduced creatinine clearance were older than those without reduced renal function (54+/-15 vs 34+/-12 years, P<0.001).


CONCLUSIONS
After a mean time of 5.4 years, a relatively high proportion of patients with epidemic poststreptococcal glomerulonephritis due to S.zooepidemicus present hypertension, reduced renal function and increased microalbuminuria.
Sesso
Ricardo
R
Division of Nephrology, Escola Paulista de Medicina, Unifesp, Rua Botucatu 740, São Paulo, SP, Brazil. rsesso@nefro.epm.br
Pinto
Sergio Wyton L
SW
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D004196:Disease Outbreaks; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D013290:Streptococcal Infections / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors
D003404:Creatinine