Long-term prognosis for endocapillary glomerulonephritis of poststreptococcal type in children and adults

Abstract

The long-term clinical course of sporadic, acute endocapillary glomerulonephritis of poststreptococcal type is reported. In all cases, the diagnosis was established by renal biopsies and in most cases by clinical tests. The study is based on retrospective/prospective data from 36 children and 101 adults in the Federal Republic of Germany, Luxemburg, and Austria. In 72 patients (21 children, 51 adults) the disease course was clinically followed over periods of 2-13 years (clinical features: blood pressure, serum creatinine, proteinuria, hematuria). In this group, the number of clinical recoveries (i.e., all features within strictly defined normal ranges) increased with increasing length of observation. Children showed more rapid clinical recovery. 29% of the children and 41% of the adults showed no clinical recovery. Out of all 137 patients, 3 progressed to chronic renal failure, and 4 other patients died. Cases with an initial nephrotic syndrome had a significantly poorer long-term prognosis (p less than 0.005). Initial elevation of serum creatinine concentration due to acute renal failure did not influence the long-term prognosis. Our results indicate that the acute endocapillary glomerulonephritis of poststreptococcal type has a slow tendency towards clinical recovery under good hygienic conditions and if unaccompanied by nephrotic syndrome in the initial phase.