Acute post-infectious glomerulonephritis in adults: a single center report

Acute post-infectious glomerulonephritis (APIGN) is uncommonly seen in adults; its incidence is progressively declining,particularly in developed countries. The aim of this study was to evaluate the epidemiological,clinical and biologic features of APIGN in a Tunisian center. A retrospective descriptive analytic study was carried out on 50 patients aged more than 15 years who were admitted to the Monastir Hospital between 1991 and 2007,with a diagnosis of APIGN. There were more males than females (66% vs. 34%),and the mean age of the patients was 36.8 ± 10 years. Only 10% had an immunocompromised background,including diabetes. The most common site of infection was upper respiratory tract,followed by skin and pneumonia. The most common causative agent was Streptococcus (66%),followed by Staphylococcus (12%). 73.8% of the patients had low C3 complement levels. The mean peak serum creatinine was 190 μmol,and 4% of patients required acute dialysis. The patients were followed-up for a mean period of 18 months (range,0.16-97 months). During follow-up,of the 46 patients reviewed in the consultation,the majority showed complete remission,12 patients had persisting abnormalities such as hypertension in 17%,chronic renal failure in 8% and proteinuria in 6.5%,and one patient had concomitant hypertension and chronic renal failure. Our study suggests that APIGN is still endemic in some parts of the world such as Tunisia,and our data showed a favorable prognosis in adults.