Long-term prognosis of epidemic poststreptococcal glomerulonephritis in Maracaibo: follow-up studies 11-12 years after the acute episode.

In 1968 there was an epidemic outbreak of acute poststreptococcal glomerulonephritis in Maracaibo during which 384 cases were hospitalized. Of these cases, 120 were recalled in 1974 and the results of their investigations were reported. The present work concerns 71 patients from this group followed for 11-12 years and studied with measurement of creatinine clearance (CCr), protein excretion and urine sediment analyses. Measurements of serum immunoglobulins, cryoglobulins, C3 levels and rheumatoid factor titers were also made. One patient developed uremia and is in chronic dialysis. Persistent abnormalities were detected in 21.1% of the patients. Depressed creatinine clearance was found in 12.6% of the patients and proteinuria (0.5-2.0 g/day) in 11.2%. Microscopic hematuria occurred in 4.1%. Only 2 patients wer hypertensive. Transient serological abnormalities were seen in 36 patients: elevated IgG levels in 27, serum cryoglobulins in 17 and a low C3 level in 1 patient. Cryoglobulins were found in 50% of the patients with abnormal renal findings and in 22.9% of the patients with normal renal function and urine sediment. Children (at the time of the epidemic) had urinary abnormalities less frequently (16.1%) than did adults (55.5%). Of 9 patients who had been found abnormal five years before, 3 were improved or normal, 3 were stable and 3 showed progressive disease. our studies indicate that uremia is rare in the first decade after epidemic poststeptococcal glomerulonephritis. Nevertheless, the increasing incidence of depressed renal function dictates the need for continued follow-up of this group of patients.