Long-term prognosis for Chinese adult patients with acute postinfectious glomerulonephritis

Abstract

The long-term prognosis for adults with acute postinfectious glomerulonephritis (APIGN) is under debate. This study was designed to investigate the long-term renal outcome of adult APIGN. A total of 64 adults with APIGN were identified and divided into two groups: acute poststreptococcal glomerulonephritis (APSGN) group and acute nonstreptococcal postinfectious glomerulonephritis (nonstreptococcal APIGN) group. For the purpose of outcome analysis, 49 patients with a follow-up of ≥ 12 months were included. Univariate and multivariate analyses were performed for prognostic factors. Nephrotic syndrome was more frequently seen in nonstreptococcal APIGN patients. At the time of biopsy, the mean proteinuria of the two groups was 1.82 ± 2.14 and 4.21 ± 4.39 g/d, respectively (p = 0.005). There was no significant difference between the two groups on microscopy. Among the 49 patients with ≥ 12 months of follow-up, the complete remission rate was 85.7%, and the incidence of chronic renal failure and endstage renal disease (ESRD) was 6.1% and 4.1%, respectively. The complete remission rate of the APSGN group was higher than that of the nonstreptococcal APIGN group. Univariate analysis showed that the prognostic factors were age, underlying disease, proteinuria, tubular damage and C1q deposits. In multivariate analysis, underlying disease was the only significant and independent inverse correlate of complete remission. The long-term prognosis for young Chinese adults with APIGN is optimistic if there is no underlying disease. The renal outcome for patients with APSGN is better than for patients with nonstreptococcal APIGN.