Infection-related glomerulonephritis: A retrospective observational study from South India

Introduction: Infection-related glomerulonephritis (IRGN) is an immunologically mediated renal injury due to non-renal infections. With time there has been a change with respect to its incidence, etiological agents, clinical features, and outcomes. Materials and methods: A retrospective observational study was conducted from May 1, 2018 to May 31, 2021. Objectives: 1. To study the clinical profile of patients with renal biopsy-proven IRGN. 2. To study the outcomes of IRGN at the end of 3 months. All patients were followed up for a minimum period of 3 months. Outcomes at the end of 3 months were categorized as any one of the following: (1) normalization of renal function tests and proteinuria < 500 mg/day, (2) persistent renal dysfunction without requirement of renal replacement therapy, (3) requirement of renal replacement therapy. Results: A total of 114 patients were included in the study. The incidence of IRGN was 4.6%. The majority were males and in the fifth decade of life. Focus of infection was identified in 59.6% of cases. Acute glomerulonephritis (35.1%) and nephrotic syndrome (35.1%) were the most common syndromic presentations. 68.4% of patients had complete recovery at the end of 3 months. 15.7% of patients progressed to chronic kidney disease, and 15.7% of patients required renal replacement therapy. Elderly patients' requirement of renal replacement therapy and higher creatinine at presentation were significantly associated with poor outcomes (p < 0.05). Conclusion: This study emphasizes the need for early identification of the source of infection and treatment with appropriate antibiotics. Strategies to identify occult sources of infection should be employed. Elderly age and requirement of renal replacement therapy were associated with poor outcomes.