BACKGROUND: The long-term health consequences of acute bacterial gastroenteritis remain uncertain. We studied the risk of hypertension and reduced kidney function after an outbreak of acute gastroenteritis due to contamination of a regional drinking water supply with Escherichia coli O157:H7 and Campylobacter species. METHODS: A total of 1958 adults with no known history of hypertension or kidney disease before the outbreak participated in a long-term follow-up study. Of the participants, 675 had been asymptomatic during the outbreak, 909 had had moderate symptoms of acute self-limited gastroenteritis, and 374 had had severe symptoms that necessitated medical attention. The outcomes of interest were a diagnosis of hypertension or the presence of reduced kidney function and albuminuria during the follow-up period. RESULTS: After a mean follow-up of 3.7 years after the outbreak, hypertension was diagnosed in 27.0% of participants who had been asymptomatic during the outbreak and in 32.3% and 35.9% of those who had had moderate and severe symptoms of acute gastroenteritis respectively (trend p = 0.009). Compared with the asymptomatic participants, those with moderate and severe symptoms of gastroenteritis had an adjusted relative risk of hypertension of 1.15 (95% confidence interval [CI] 0.97-1.35) and 1.28 (95% CI 1.04-1.56) respectively. A similar graded association was seen for reduced kidney function, defined as the presence of an estimated glomerular filtration rate below 60 mL/min per 1.73 m2 (trend p = 0.03). No association was observed between gastroenteritis and the subsequent risk of albuminuria. INTERPRETATION: Acute bacterial gastroenteritis necessitating medical attention was associated with an increased risk of hypertension and reduced kidney function 4 years after infection. Maintaining safe drinking water remains essential to human health, as transient bacterial contaminations may have implications well beyond a period of acute self-limited illness.
BACKGROUND: The long-term health consequences of acute bacterial gastroenteritis remain uncertain. We studied the risk of hypertension and reduced kidney function after an outbreak of acute gastroenteritis due to contamination of a regional drinking water supply with Escherichia coli O157:H7 and Campylobacter species. METHODS: A total of 1958 adults with no known history of hypertension or kidney disease before the outbreak participated in a long-term follow-up study. Of the participants, 675 had been asymptomatic during the outbreak, 909 had had moderate symptoms of acute self-limited gastroenteritis, and 374 had had severe symptoms that necessitated medical attention. The outcomes of interest were a diagnosis of hypertension or the presence of reduced kidney function and albuminuria during the follow-up period. RESULTS: After a mean follow-up of 3.7 years after the outbreak, hypertension was diagnosed in 27.0% of participants who had been asymptomatic during the outbreak and in 32.3% and 35.9% of those who had had moderate and severe symptoms of acute gastroenteritis respectively (trend p = 0.009). Compared with the asymptomatic participants, those with moderate and severe symptoms of gastroenteritis had an adjusted relative risk of hypertension of 1.15 (95% confidence interval [CI] 0.97-1.35) and 1.28 (95% CI 1.04-1.56) respectively. A similar graded association was seen for reduced kidney function, defined as the presence of an estimated glomerular filtration rate below 60 mL/min per 1.73 m2 (trend p = 0.03). No association was observed between gastroenteritis and the subsequent risk of albuminuria. INTERPRETATION: Acute bacterial gastroenteritis necessitating medical attention was associated with an increased risk of hypertension and reduced kidney function 4 years after infection. Maintaining safe drinking water remains essential to human health, as transient bacterial contaminations may have implications well beyond a period of acute self-limited illness.
Authors: Antonetta H J M Pijpers; Petra A VAN Setten; Lambertus P W J VAN DEN Heuvel; Karel J M Assmann; Hendrikus B P M Dijkman; Arie H M Pennings; Leo A H Monnens; Victor W M VAN Hinsbergh Journal: J Am Soc Nephrol Date: 2001-04 Impact factor: 10.121
Authors: Amit X Garg; Jennifer Macnab; William Clark; Joel G Ray; John K Marshall; Rita S Suri; P J Devereaux; Brian Haynes Journal: Can J Public Health Date: 2005 Mar-Apr
Authors: Camille A Jones; Mildred E Francis; Mark S Eberhardt; Blanche Chavers; Josef Coresh; Michael Engelgau; John W Kusek; Danita Byrd-Holt; K M Venkat Narayan; William H Herman; Camara P Jones; Marcel Salive; Lawrence Y Agodoa Journal: Am J Kidney Dis Date: 2002-03 Impact factor: 8.860
Authors: T Hannu; L Mattila; H Rautelin; P Pelkonen; P Lahdenne; A Siitonen; M Leirisalo-Repo Journal: Rheumatology (Oxford) Date: 2002-03 Impact factor: 7.580
Authors: Josef Coresh; Brad C Astor; Geraldine McQuillan; John Kusek; Tom Greene; Frederick Van Lente; Andrew S Levey Journal: Am J Kidney Dis Date: 2002-05 Impact factor: 8.860
Authors: Amit X Garg; John Marshall; Marina Salvadori; Heather R Thiessen-Philbrook; Jennifer Macnab; Rita S Suri; R Brian Haynes; Janet Pope; William Clark Journal: J Clin Epidemiol Date: 2006-01-27 Impact factor: 6.437
Authors: Patricia Hizo-Abes; William F Clark; Jessica M Sontrop; Ann Young; Anjie Huang; Heather Thiessen-Philbrook; Peter C Austin; Amit X Garg Journal: CMAJ Date: 2012-11-19 Impact factor: 8.262
Authors: Louise Moist; Jessica M Sontrop; Amit X Garg; William F Clark; Rita S Suri; Robert Gratton; Marina Salvadori; Immaculate Nevis; Jennifer J Macnab Journal: J Clin Hypertens (Greenwich) Date: 2010-08 Impact factor: 3.738
Authors: Janne Laine; Jukka Lumio; Salla Toikkanen; Mikko J Virtanen; Terhi Uotila; Markku Korpela; Eila Kujansuu; Markku Kuusi Journal: PLoS One Date: 2014-01-17 Impact factor: 3.240