[In Process Citation].
Postinfectious glomerulonephritis is an immune-mediated disease occurring as a result of the host response to an extrarenal infection. The classical form of poststreptococcal disease is decreasing worldwide but remains a significant health care problem in developing countries, especially in children. In industrialised countries postinfectious glomerulonephritis is now primarily due to non-streptococcal disease. In elderly patients with risk factors such as diabetes mellitus, alcohol-dependency or neoplasia and in intravenous drug users postinfectious glomerulonephritis is most often associated with staphylococcal infections of various locations. Compared to the good outcome of classical poststreptococcal glomerulonephritis the severity of the nephritic syndrom is increased and the prognosis is worse, especially if pre-existing renal disease such as diabetic or vascular nephropathy is present. The recognition and adequate therapy, often including surgical measures, of the primary focus of infection is of utmost importance to improve the outcome of this condition. Especially in patients with diabetic foot syndrome and in intravenous drug users with signs of infection and renal insufficiency or abnormal urinalysis, there should be a high index of suspicion for postinfectious glomerulonephritis.
Abteilung für Nephrologie, Departement Medizin, Kantonsspital, Luzern.
Andreas
A
Fischer
D000368:Aged; D001706:Biopsy; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008854:Microscopy, Electron; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*