Tubular proteinuria and glomerular filtration 6 years after puumala hantavirus-induced acute interstitial nephritis.
OBJECTIVE
We previously found increased urinary protein excretion, glomerular filtration rate (GFR) and blood pressure in a retrospective analysis of patients with previous nephropathia epidemica (NE). Here, we evaluated the long-term outcome after NE in a prospectively recruited patient group.


METHODS
Proteinuria, GFR and ambulatory 24-hour blood pressure were assessed 4-7 years (mean 6) after acute NE in 37 patients, and these values were compared to those from 38 seronegative controls.


RESULTS
Six years after NE, the prevalence of elevated urinary alpha(1)-microglobulin excretion was higher in the patients than controls (9/35 vs. 1/38; p = 0.005). The patients also had higher urinary protein excretion (0.17 +/- 0.05 vs. 0.14 +/- 0.04 g/day; p = 0.006), GFR (119 +/- 19 vs. 109 +/- 14 ml/min/1.73 m(2); p = 0.016) and mean systolic (123 +/- 11 vs. 117 +/- 9 mm Hg; p = 0.012), nighttime systolic (109 +/- 11 vs. 100 +/- 9 mm Hg; p = 0.001) and nighttime diastolic blood pressure (70 +/- 7 vs. 66 +/- 7 mm Hg; p = 0.035) than the controls.


CONCLUSIONS
These results confirm our previous findings of a higher prevalence of tubular proteinuria and increased urinary protein excretion, GFR and systolic blood pressure 6 years after acute NE.
Miettinen
Marja H
MH
Department of Internal Medicine, Central Hospital of Jyvaskyla, Jyvaskyla, Finland. marja.miettinen@ksshp.fi
Makela
Satu M
SM
Ala-Houhala
Ilpo O
IO
Huhtala
Heini S
HS
Koobi
Tiit
T
Vaheri
Antti I
AI
Pasternack
Amos I
AI
Porsti
Ilkka H
IH
Mustonen
Jukka T
JT
D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006480:Hemorrhagic Fever with Renal Syndrome / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007687:Kidney Tubules, Proximal / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000175:diagnosis* / Q000209:etiology*; D011507:Proteinuria / Q000175:diagnosis* / Q000209:etiology*