@article {Garg261, author = {Amit X. Garg and Louise Moist and Douglas Matsell and Heather R. Thiessen-Philbrook and R. Brian Haynes and Rita S. Suri and Marina Salvadori and Joel Ray and William F. Clark}, editor = {,}, title = {Risk of hypertension and reduced kidney function after acute gastroenteritis from bacteria-contaminated drinking water}, volume = {173}, number = {3}, pages = {261--268}, year = {2005}, doi = {10.1503/cmaj.050581}, publisher = {CMAJ}, abstract = {Background: The long-term health consequences of acute bacterial gastroenteritis remain uncertain. We studied the risk of hypertension and reduced kidney function after an outbreak of acute gastroenteritis due to contamination of a regional drinking water supply with Escherichia coli O157:H7 and Campylobacter species. Methods: A total of 1958 adults with no known history of hypertension or kidney disease before the outbreak participated in a long-term follow-up study. Of the participants, 675 had been asymptomatic during the outbreak, 909 had had moderate symptoms of acute self-limited gastroenteritis, and 374 had had severe symptoms that necessitated medical attention. The outcomes of interest were a diagnosis of hypertension or the presence of reduced kidney function and albuminuria during the follow-up period. Results: After a mean follow-up of 3.7 years after the outbreak, hypertension was diagnosed in 27.0\% of participants who had been asymptomatic during the outbreak and in 32.3\% and 35.9\% of those who had had moderate and severe symptoms of acute gastroenteritis respectively (trend p = 0.009). Compared with the asymptomatic participants, those with moderate and severe symptoms of gastroenteritis had an adjusted relative risk of hypertension of 1.15 (95\% confidence interval [CI] 0.97{\textendash}1.35) and 1.28 (95\% CI 1.04{\textendash}1.56) respectively. A similar graded association was seen for reduced kidney function, defined as the presence of an estimated glomerular filtration rate below 60 mL/min per 1.73 m2 (trend p = 0.03). No association was observed between gastroenteritis and the subsequent risk of albuminuria. Interpretation: Acute bacterial gastroenteritis necessitating medical attention was associated with an increased risk of hypertension and reduced kidney function 4 years after infection. Maintaining safe drinking water remains essential to human health, as transient bacterial contaminations may have implications well beyond a period of acute self-limited illness.}, issn = {0820-3946}, URL = {https://www.cmaj.ca/content/173/3/261}, eprint = {https://www.cmaj.ca/content/173/3/261.full.pdf}, journal = {CMAJ} }