Evidence map›Paper›PMID 37492933›Full record

ArticleNephrology (Carlton, Vic.)2023

Bacterial infection-related glomerulonephritis in patients with diabetes.

Elenjickal Elias John, Sanjeet Roy, Jeethu Joseph Eapen, Reka Karuppusami, Nisha Jose, Selvin Sundar Raj Mani, Joseph Johny, Rizwan Alam, Sabina Yusuf, Athul Thomas and 4 more

Abstract read
In one paragraph

Article in Nephrology (Carlton, Vic.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Elenjickal Elias JohnDepartment of Nephrology, Christian Medical College, Vellore, India.ORCID https://orcid.org/0000-0003-4138-8390
Sanjeet RoyDepartment of Pathology, Christian Medical College, Vellore, India.
Jeethu Joseph EapenDepartment of Nephrology, Christian Medical College, Vellore, India.
Reka KaruppusamiDepartment of Biostatistics, Christian Medical College, Vellore, India.
Nisha JoseDepartment of Nephrology, Christian Medical College, Vellore, India.
Selvin Sundar Raj ManiDepartment of Nephrology, Christian Medical College, Vellore, India.ORCID https://orcid.org/0000-0003-4141-1175
Joseph JohnyDepartment of Nephrology, Christian Medical College, Vellore, India.ORCID https://orcid.org/0000-0002-3397-8510
Rizwan AlamDepartment of Nephrology, Christian Medical College, Vellore, India.
Sabina YusufDepartment of Nephrology, Christian Medical College, Vellore, India.
Athul ThomasDepartment of Nephrology, Christian Medical College, Vellore, India.
Anna T ValsonDepartment of Nephrology, Christian Medical College, Vellore, India.
Vinoi George DavidDepartment of Nephrology, Christian Medical College, Vellore, India.
Santosh VarugheseDepartment of Nephrology, Christian Medical College, Vellore, India.
Suceena AlexanderDepartment of Nephrology, Christian Medical College, Vellore, India.ORCID https://orcid.org/0000-0001-7692-606X

Funding

DBT-Wellcome Trust India Alliance IA/CPHS/22/1/506541
6 · The paper itself

Abstract

aimDiabetic patients are prone to infections, thus making them a unique cohort at risk of developing bacterial infection-related glomerulonephritis (IRGN).

methodsIn total, 1693 adult diabetic patients underwent kidney biopsy between 2005 and 2021 at our tertiary care hospital in South India. Of these, 121 consecutive cases which met criteria of bacterial IRGN were included in this study.

resultsThe mean age of the cohort was 53.1 ± 10.1 years and 83/121 (68.5%) were males. Majority (98.3%) had type 2 diabetes for a median duration of 6 (IQR, 2-12) years. The most common sites of infection were skin (47/121, 38.8%) and urinary tract (15/121, 12.4%). Fifty percent (58/121) of patients had underlying advanced diabetic kidney disease (DKD). Isolated C3 deposits (without immunoglobulin) occurred in 66/121 (54.5%) patients predominantly in advanced DKD patients. IgA-dominant glomerulonephritis occurred in only 9/121 (7.4%) patients. Short-course oral steroid was given to 86/121 (71.1%) patients. Steroid related dysglycemia and immunosuppression related infections occurred in 9/61 (14.8%) and 16/61 (26.2%) patients respectively. Of the 90 patients with follow up details >3 months, 46 (51.1%) progressed to kidney failure over a median period of 0.5 (IQR, 0-7.2) months. Patients diagnosed in the latter half of our study period (2013-2021) were older, less commonly presented with fever, had more pronounced hypocomplementemia and severe renal histology predominantly with a 'starry sky' immunofluorescence pattern.

conclusionSuperimposed bacterial IRGN on underlying DKD is associated with poor renal outcomes. Use of short course steroid was associated with significant toxicity.

Indexed as

Bacterial InfectionsDiabetes Mellitus, Type 2GlomerulonephritisGlomerulonephritis, IGAAdultBiopsyFemaleHumansKidneyMaleMiddle AgedSteroidsSteroidsdiabetic nephropathyfibrosisglomerulonephritisimmunopathologyinfectious diseasesrenal failure

Identifiers

PMID37492933
PMCPMC7615861

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.