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Tubular Proteinuria and Glomerular Filtration 6 Years after Puumala Hantavirus-Induced Acute Interstitial Nephritis

Miettinen M.H.a · Mäkelä S.M.b, d · Ala-Houhala I.O.b, d · Huhtala H.S.c · Kööbi T.e · Vaheri A.I.f · Pasternack A.I.b · Pörsti I.H.b, d · Mustonen J.T.b, d
aDepartment of Internal Medicine, Central Hospital of Jyväskylä, Jyväskylä, bMedical School, cTampere School of Public Health, University of Tampere,Departments of dInternal Medicine and eClinical Physiology, Tampere University Hospital, Tampere, and fDepartment of Virology, Haartman Institute, University of Helsinki, Helsinki, Finland Nephron Clin Pract 2009;112:c115–c120 (DOI:10.1159/000213899)


Background/Aims: We previously found increased urinary protein excretion, glomerular filtration rate (GFR) and blood pressure in a retrospective analysis of patients with previous nephropathia epidemica (NE). Here, we evaluated the long-term outcome after NE in a prospectively recruited patient group. Methods: Proteinuria, GFR and ambulatory 24-hour blood pressure were assessed 4–7 years (mean 6) after acute NE in 37 patients, and these values were compared to those from 38 seronegative controls. Results: Six years after NE, the prevalence of elevated urinary α1-microglobulin excretion was higher in the patients than controls (9/35 vs. 1/38; p = 0.005). The patients also had higher urinary protein excretion (0.17 ± 0.05 vs. 0.14 ± 0.04 g/day; p = 0.006), GFR (119 ± 19 vs. 109 ± 14 ml/min/1.73 m2; p = 0.016) and mean systolic (123 ± 11 vs. 117 ± 9 mm Hg; p = 0.012), nighttime systolic (109 ± 11 vs. 100 ± 9 mm Hg; p = 0.001) and nighttime diastolic blood pressure (70 ± 7 vs. 66 ± 7 mm Hg; p = 0.035) than the controls. Conclusions: These results confirm our previous findings of a higher prevalence of tubular proteinuria and increased urinary protein excretion, GFR and systolic blood pressure 6 years after acute NE.


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