Infective endocarditis: long-term reversibility of kidney function impairment. A 1-y post-discharge follow-up study

Scand J Infect Dis. 2010 Jul;42(6-7):484-90. doi: 10.3109/00365541003694764.

Abstract

The aim of this study was to quantify the long-term reversibility of kidney function decrease occurring during hospitalization and treatment for infective endocarditis (IE). A prospective observational cohort study was performed at a tertiary university hospital in Copenhagen from October 2002 through May 2008; 223 consecutive IE patients were included. Forty patients died in hospital and 38 within 1 y of discharge. Of the 145 patients called in for the 1-y follow-up, 111 accepted. Kidney function was assessed by estimated endogenous creatinine clearance (EECC). Statistical correlation between EECC at admission, discharge and follow-up, as well as correlations between gentamicin and EECC changes, were analyzed. In the 111 follow-up patients, the bacteriological aetiologies were: Streptococcus species (47.7%), Enterococcus (16.2%) and Staphylococcus aureus (11.7%). The mean EECC decrease from admission to discharge was 8.4% (95% confidence interval 1.6-15.2; p < 0.001). However this kidney function impairment was reversed at the 1-y follow-up. When divided into subgroups, a full kidney function restitution was seen in only 35.1% of patients with an EECC decrease of >22%. In conclusion, kidney function impairment occurring during hospitalization for IE is potentially reversible within the first y post-discharge.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Creatinine* / blood
  • Creatinine* / metabolism
  • Endocarditis* / complications
  • Endocarditis* / drug therapy
  • Endocarditis* / epidemiology
  • Female
  • Follow-Up Studies
  • Gentamicins / adverse effects
  • Gentamicins / therapeutic use
  • Humans
  • Kidney Diseases / etiology
  • Kidney Diseases / metabolism*
  • Kidney Diseases / physiopathology
  • Kidney Function Tests*
  • Linear Models
  • Male
  • Middle Aged
  • Statistics, Nonparametric

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Creatinine