Long-term follow-up of patients presenting to adult nephrologists with chronic pyelonephritis and 'normal' renal function

We studied the natural history, and therefore prognosis, of patients with c hronic pyelonephritis presenting to adult nephrologists with a plasma or se rum creatinine <90 mmol/l. From the Newcastle chronic pyelonephritis databa se, 255 patients with radiologically-proven disease were reviewed. Median f ollow-up was 95 months (95%CI 82.3-109.3). Plasma creatinine was <less than or equal to>90 mu mol/l (P(Cr)less than or equal to 90 group) at presentat ion in 138. At presentation, hypertension, bilateral disease and proteinuri a were less frequent in the P(Cr)less than or equal to 90 group (hypertensi on 19% vs. 32%, p<0.05; bilateral disease 25% vs. 70%, p<0.001; proteinuria 18% vs. 60%, p<0.001). With the exception of two patients, the renal progn osis of this group was excellent. Patients over the age of 18 years present ing to adult nephrologists with a diagnosis of chronic pyelonephritis and a creatinine <less than or equal to>90 mu mol/l can be reassured that the ch ances of developing end-stage renal failure in the future are very small. M ost could be referred back to their general practitioner for long-term foll ow-up.