PT  - JOURNAL ARTICLE
AU  - Amit X. Garg
AU  - Louise Moist
AU  - Douglas Matsell
AU  - Heather R. Thiessen-Philbrook
AU  - R. Brian Haynes
AU  - Rita S. Suri
AU  - Marina Salvadori
AU  - Joel Ray
AU  - William F. Clark
ED  - ,
TI  - Risk of hypertension and reduced kidney function after acute gastroenteritis from bacteria-contaminated drinking water
AID  - 10.1503/cmaj.050581
DP  - 2005 Aug 02
TA  - Canadian Medical Association Journal
PG  - 261--268
VI  - 173
IP  - 3
4099  - http://www.cmaj.ca/content/173/3/261.short
4100  - http://www.cmaj.ca/content/173/3/261.full
SO  - CMAJ2005 Aug 02; 173
AB  - 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] 0.97–1.35) and 1.28 (95% CI 1.04–1.56) 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.