Renal disease in infective endocarditis in intravenous drug users: clinical characteristics and tubulo-interstitial damage


E.Yu. Ponomareva, M.A. Tiapkina, A.P. Rebrov

State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky of Ministry of Health of Russian Federation , Saratov
Aim. Clinical characteristics of renal disease infective endocarditis (IE) in intravenous drug users (IVDU).
Methods. In 44 patients – IVDU with IE and 44 patients – non-IVDU with IE (control group) signs of renal disease were analysed: glomerular filtration rate (eGFR) was estimated according to MDRD formula; albuminuria, urinary concentration of -1-microglobulin, urinary activity of -glutamyl-transferase (GT) and lactate-dehydrogenase (LDH) were determined. Systemic markers of inflammation (serum C-reactive protein level, serum circulating immune complex level) were analysed.
Results. IVDU with IE had higher proteinuria, more prominent hematuria, and lover levels of eGFR. 23% of IVDU with IE had nephrotic syndrome without hypercholesterolemia. IVDU with IE also demonstrated elevation of urinary activity of LDH. Signs of glomerular and tubule-interstitial damage correlated with systemic inflammatory response and Staphylococcus spp. as a causative agent of IE.
Conclusion. Signs of renal disease (glomerular and tubulo-interstitial damage) are more prominent in intravenous drugs users with infective endocarditis.

About the Autors


Ponomareva E.Yu. – associate professor at hospital therapy department of Medical Faculty State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky Ministry of Health of Russian Federation, Ph.D.;
Tiapkina M.A. – assistant at hospital therapy department of Medical Faculty State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky of Ministry of Health of Russian Federation;
Rebrov A.P. – professor, honored physician of Russian Federation, head of hospital therapy department of Medical Faculty, vice-rector on medical work and post diploma education at State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky of Ministry of Health of Russian Federation, Ph.D.


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