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Changing epidemiology of Infection related glomerulonephritis from an indolent course into more dramatic presentation and outcomes conferred newer insights to the prevailing pathogenesis and pathophysiology. In the yester years, IRGN was mostly limited to children and was considered to be benign secondary to streptococcal respiratory tract and skin infection. As the time elapsed, we see staphylococcal infections as the most common culprit, more so in adults in whom the presentation and outcomes sometimes are gloomy. In adults’ various factors implicated in causation of IRGN diabetes mellitus, malignancy, alcoholism and intravenous drug abuse.
In this context, this study is undertaken to study the epidemiology, clinical presentation, various spectrum of infections and outcomes of IRGN. Institutional ethical committee clearance is taken .The current study is both retrospective and prospective data collected from August 2022 to February 2023 from patients presented with features consistent with IRGN. Renal biopsy is done in cases of rapidly progressive renal failure or persistent nephrotic proteinuria. Evaluation for underlying possible source of infection are documented. Laboratory evaluation, apart from routine blood chemistry, specific investigations include Complement levels, blood culture, urine culture, dental examination, ENT evaluation, bone and musculoskeletal screening in relevant cases, 2DEcho, fever profile, ASO titers, fundus examination, serology for HIV, HBsAg and HCV and other tropical infections like Dengue, Leptospira, Malaria and scrub. Data regarding the treatment, need for renal replacement therapy are collected.Patients are followed post discharge at 1 month, 3 months and 6 months. Hypertension, renal dysfunction, proteinuria, complement levels and active sediment are assessed during the time of follow up.
Data is captulated. Final data will be presented in the WCN congress.
Quesstionairre
QUESTIONAIRE
Name
Age
Gender
Occupation
Resident of
Phone
History of Fever/hematuria/sore throat/skin lesions/dental caries/oliguria/hypertension/edema
Other systems- rash, joint pains, diarrhea, jaundice, seizures, bleeding
Family history of similar illness
Epidemic or sporadic onset
Clinical syndrome Nephrotic-nephritic/ Acute Nephritic illness/ RPRF /AKI
Co Morbidities HTN/DM/CAD/TB/IV Drug abuse/ Malignancy
Investigations
CBP
CRP
RFT
LFT
LDH
ESR
24 hr protein
UPCR
CUE
ASO titres
Blood culture
Urine culture
Dental examination
ENT examination
Fundus
Fever profile (in relevant cases)- Smear for Malarial parasite, Dengue IgG and IgM; NS1; Leptospira antibodies; Scrub typus antibodies.
Complement levels (C3 and C4)
ANA and ANCA levels are done when relevant
CXR PA VIEW
USG
Renal biopsy
Renal replacement therapy
IRGN is a self limiting glomerulonephritis. Nevertheless timely follow up of cases help us understand the changing pathogenesis, pathophysiology and outcome of the patients with IRGN.