title: The pattern of histologically-proven acute post-infectious glomerulonephritis in Tunisian adults seen in 1976-2004.
abstract: BACKGROUND
  Acute post-infectious glomerulonephritis (APIGN) is uncommon in adults. It is widely recognized that the prognosis of APIGN is good in children. There is however little information about its long-term prognosis in adults.
  
  
  METHODS
  Between December 1976 and October 2004, 148 adult cases of APIGN were managed in our center. We retrospectively reviewed these patients' records and evaluated their clinical course and outcome.
  
  
  RESULTS
  The mean age of studied patients was 36 ± 15 years, and the male to female ratio was 2.3. The most common site of preceding infection was the respiratory tract (68.8%). At presentation, 89.2% had nephritic syndrome and 9.4% had rapidly progressive glomerulonephritis. Proteinuria was observed in 99.3%, hematuria in 95.3%, peripheral edema in 89.2% and hypertension in 81.8%. Most patients (60.7%) had acute kidney injury and four patients (2.7%) required dialysis. Renal biopsy showed diffuse endocapillary proliferative glomerulonephritis in 88.8% of patients, associated with extracapillary proliferation in 12%. After a median follow-up of 2.5 year, only two patients died and 16.12% of patients had persistent clinical and/or biological abnormality. Chronic kidney disease was noted in 10 patients (6.75%) including four patients (2.7%) who progressed to end-stage renal disease. Poor prognostic factors included nephrotic range proteinuria, extracapillary proliferation in renal biopsy, acute kidney injury and the need for dialysis.
  
  
  CONCLUSIONS
  In this cohort of patients, APIGN progressed to chronic kidney disease in less than 10% of patients.
authors.affiliation: Department of Medicine A, Laboratory of Kidney Pathology (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia. imedhelal@voila.fr
authors.forename: Imed
authors.initials: I
authors.lastname: Helal
authors.forename: Hayet
authors.initials: H
authors.lastname: Kaaroud
authors.forename: Rym
authors.initials: R
authors.lastname: Goucha
authors.forename: Fatma
authors.initials: F
authors.lastname: Ben Moussa
authors.forename: Hedi
authors.initials: H
authors.lastname: Ben Maiz
authors.forename: Adel
authors.initials: A
authors.lastname: Kheder
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy; D000328:Adult; D018450:Disease Progression; D004487:Edema / Q000209:etiology; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000382:microbiology* / Q000473:pathology*; D006417:Hematuria / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007239:Infections / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D014416:Tunisia; D055815:Young Adult