Infection-related glomerulonephritis: changing demographics and outcomes.
Infection-related glomerulonephritis: changing demographics and outcomes.
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感染相关性肾小球肾炎：人口统计和结果的变化。
DOI：
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发表时间：
2012
影响因子：
2.9
通讯作者：
C. Nast
中科院分区：
文献类型：
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作者：
C. Nast
感染后肾小球肾炎（PIGN）是一种典型的免疫介导感染相关性肾小球肾炎，继发于非肾脏感染。它的流行病学在过去几十年中一直在发生变化，最近的数据表明全球下降，特别是在发达国家。这是由于更好和更早地治疗感染，以及生活条件和营养的改善。目前受影响的患者群体往往年龄较大，有更多的成年人患有这种疾病，特别是那些患有糖尿病等合并症的患者；大约三分之一的成年PIGN患者至少有一种合并症因素。引起PIGN的微生物也在发生变化，与链球菌有关的病例减少，与葡萄球菌有关的病例增加。以iga为主的PIGN已被广泛认为是一种常见于糖尿病或其他形式慢性疾病的成人患者的病变，具有更严重的临床表现和更谨慎的结局。儿童的预后和转归最好，其次是健康成人，成人的合并症因素在PIGN后表现出更多的慢性肾损伤。重要的是要意识到PIGN的这些变化特征，因为受影响的患者群体具有较高的肾脏预后不良风险。
Postinfectious glomerulonephritis (PIGN) is the classic form of immune-mediated infection-associated glomerulonephritis following a nonrenal infection. Its epidemiology has been changing over the past several decades, with recent data indicating a global decline, particularly in developed countries. This is owing to better and earlier treatment of infections, and improvements in living conditions and nutrition. The currently affected patient population tends to be older, with more adults developing the disease, especially those with comorbidities such as diabetes; approximately one-third of adults with PIGN will have at least one comorbid factor. Organisms causing PIGN are also changing, with fewer cases associated with Streptococcus and more cases owing to Staphylococcus. IgA-dominant PIGN has become more widely recognized as a lesion usually found in adult patients with diabetes or another form of chronic illness, with more severe clinical manifestations and a more guarded outcome. Children have the best prognosis and outcome followed by healthy adults, with adults having comorbid factors exhibiting more chronic renal injury following PIGN. It is important to be aware of these shifting features of PIGN, as the impacted patient population is at higher risk for poor renal outcome.