Analysis of clinical presentation, pathological spectra, treatment and outcomes of biopsy‐proven acute postinfectious glomerulonephritis in adult indigenous people of the Northern Territory of Australia

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Indigenous Australians of the Northern Territory (NT) suffer some of the highest rates of chronic kidney disease (CKD) in the world1 (Fig. 1). Childhood acute post streptococcal glomerulonephritis (APSGN) has been shown as a major risk factor in some studies.4 A recent multi‐determinant model of renal disease in a remote Australian Aboriginal population in the context of early life risk factors: lower birth weight, childhood APSGN and current body mass index (BMI) showed that in young Aboriginal adults, albumin/creatinine ratio (ACR) levels were higher in those with high BMIs, most notably in those with lower birth weights or an APSGN history or both. The high disease burden in this population was explained by high rates of the early life risk factors, low birth weight and APSGN.4
A nationwide study of renal biopsy findings among 643 renal biopsies from indigenous Australians compared with 249 non‐indigenous showed indigenous patients had higher rates of segmental sclerosis, acute postinfectious glomerulonephritis (APIGN) and mixed morphologies.8
The rates of APIGN have significantly decreased in developed countries including Australia but remain high in indigenous communities in the NT.
A study of APSGN from the notifiable diseases surveillance system in the NT concluded that APSGN rates in remote indigenous communities are comparable with or higher than those in developing countries.9
There are high rates of infectious diseases, diabetes mellitus (DM), alcohol consumption and other co‐morbidities associated with the risk of APIGN.
Although there are significant published data on high prevalence of APSGN in childhood and its association with the development of CKD in later life in indigenous populations, the impact of APIGN and its clinical spectra in adult indigenous people of the NT has not been studied in detail.
We analysed the clinical presentation, pathological spectra, treatment and outcomes of biopsy‐proven APIGN in the NT over a 10‐year period.
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