Non-streptococcal Bacteria as the Leading Cause of Infection-related Glomerulonephritis in Adults

Abstract

Infection-related glomerulonephritis (IRGN) is a kidney disorder characterized by inflammation of the glomeruli, the kidney's filtering units, triggered by infections elsewhere in the body. Recent data reveal a shift in the United States, with non-streptococcal bacteria emerging as significant causes of IRGN in adults, replacing the historical dominance of streptococcal infections. This condition arises when the body's immune response to an infection deposes immune complexes in the kidney's glomeruli, resulting in inflammation and damage. Factors like the type and virulence of the bacteria, host immune response, and genetic predisposition contribute to its pathogenesis. Non-streptococcal bacterial infections, including staphylococcal and Escherichia coli (E. coli), are now prominent contributors to adult IRGN. This shift in epidemiology may vary over time and by region. Patients with non-streptococcal bacterial IRGN commonly present with acute kidney injury symptoms, such as swelling, hypertension, hematuria, and proteinuria. Diagnosis involves clinical evaluation, laboratory tests, and kidney biopsy to reveal characteristic glomerular changes. Management focuses on treating the underlying infection with targeted antibiotics, controlling inflammation, and providing supportive care. Severe cases may require dialysis until kidney function recovers. This comprehensive narrative review aims to provide an up-to-date perspective on non-streptococcal bacteria as the leading cause of IRGN in adults. It covers epidemiology, etiology, clinical presentation, diagnosis, and treatment. The prognosis varies based on factors such as the underlying infection and promptness of intervention. This evolving landscape underscores the importance of early diagnosis and tailored management to enhance outcomes in changing IRGN epidemiology among adults. Staying vigilant in diagnosing and managing IRGN remains crucial as it presents new challenges and opportunities for improved patient care.