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Long-term Follow-up

Ruby Meiland, MD, PhD; Ronald P. Stolk, MD, PhD; Suzanne E. Geerlings, MD, PhD; Petra H. M. Peeters, MD, PhD; Diederick E. Grobbee, MD, PhD; Frank E. J. Coenjaerts, PhD; Ellen C. Brouwer; Andy I. M. Hoepelman, MD, PhD

Arch Intern Med. 2007;167(3):253-257.

Background  We sought to investigate whether Escherichia coli bacteriuria is associated with a decline in renal function or with the development of end-stage renal failure after long-term follow-up.

Methods  We performed a full cohort analysis for women who participated in 2 population-based studies. The baseline cohort consisted of women who collected morning midstream urine samples that were stored. In the cohort study, the presence of E coli bacteriuria was subsequently determined by real-time polymerase chain reaction. After a mean ± SD follow-up of 11.5 ± 1.7 years, blood samples were drawn from 490 women. In the nested case-control study, cases comprised all women who underwent kidney therapy (hemodialysis or renal transplantation) between participation in the baseline cohort study and a mean ± SD of 13.8 ± 7.4 years later.

Results  The mean ± SD age at baseline was 45.0 ± 3.2 years, and 48 women (10%) had E coli bacteriuria. After 11.5 years, the mean ± SD creatinine clearance (Cockroft-Gault formula) was similar between the 2 groups (87 ± 21 mL/min [1.5 ± 0.4 mL/s] and 85 ± 18 mL/min [1.4 ± 0.3 mL/s] for women who had and those who did not have bacteriuria, respectively). In the nested case-control study, the prevalence of E coli bacteriuria was 14% among cases and control subjects. The odds ratio corrected for age for the development of end-stage renal failure in the presence of E coli bacteriuria at baseline was 1.1 (95% confidence interval, 0.4-2.8; P = .86).

Conclusion  Escherichia coli bacteriuria is not associated with a decline in renal function or with the development of end-stage renal failure in a population of generally healthy women during 12 to 14 years of follow-up.

Author Affiliations: Department of Internal Medicine and Infectious Diseases (Dr Meiland), the Julius Center for Patient Oriented Research (Drs Peeters and Grobbee), the Eijkman Winkler Laboratory for Medical Microbiology (Dr Coenjaerts and Hoepelman and Ms Brouwer), and Department of Internal Medicine and Infectious Diseases (Dr Hoepelman), University Medical Center, Utrecht; Department of Epidemiology, University Medical Center of Groningen, Groningen(Dr Stolk); and Center for Infection and Immunity Amsterdam, Academic Medical Center, Amsterdam (Dr Geerlings), the Netherlands.