SAN DIEGO--Renal scars and moderately reduced renal function are common in women with previous acute pyelonephritis, but long-term serious clinical complications appear to be rare, Dr. Raul Raz said at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
Those conclusions came from one of the few studies to evaluate long-term complications in women who develop acute pyelonephritis as adults, said Dr. Raz of the Technion School of Medicine, Haifa, Israel.
Of 63 women aged 18 years and older who had been hospitalized with acute pyelonephritis between January 1982 and December 1992, 29 (46%) were found to have renal scars 10 or more years later on dimercaptosuccinic acid scans, while 34 (54%) did not. Pregnancy and hypoalbuminemia at the time of hospitalization were the only two independent factors related to the presence of renal scars at a mean of about 17 years follow-up. Of the women with renal scars, 19 (65.5%) were pregnant at the time of hospitalization, compared with just 10(34.5%) of the women without scars. Mean serum albumin levels were 3.2 g/dL among the women with renal scars and 3.6 g/dL among those without.
Overall, pregnancy increased the risk for scars fourfold, while women with a serum albumin level of less than 3.2g/ dL were at more than 12 times greater risk, she said.
Women with renal scars were more likely to have moderate reductions in renal function. Mean glomerular filtration rates were 88 mL/min among the women with scars, compared with 105 mL/min in those without. Four women with renal scars--but none without--had significantly impaired renal function.
Rates of recurrent urinary tract infections and of arterial hypertension at follow-up did not differ between groups. Approximately one-fourth of the women in each group had each of those complications.
COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group
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