Abstract
Fifity women with pyelonephritic renal scarring were prospectively followed for five years and the changes in renal function were related to blood pressure control, plasma renin activity, urinary albumin excretion and the incidence of urinary tract infections (UTI). Five patients (10%) developed end stage renal disease. All these patients had bilateral disease, proteinuria and anti-hypertensive treatment at presentation. The mean ± SD glomerular filtration rate (GFR) of all patients with renal scarring was 74 ± 27 ml/min × 1.73 m2 at presentation which was significantly lower than the GFR in 55 patients with a recent episode of acute pyelonephritis (p < 0.001) and 10 healthy controls (p < 0.001). GFR and age corrected GFR decreased significantly during follow-up (p < 0.001 and p < 0.02 respectively). The decrease in GFR was significantly higher in patients with bilateral scarring, in patients on blood pressure treatment and in patients with an episode of symptomatic UTI during follow-up. Eight patients (1...
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