Management and Clinical Outcomes of Membranous Nephropathy, IgA Nephropathy, and Minimal Change Disease Two Years Post-Kidney Biopsy.

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  • Additional Information
    • Source:
      Publisher: Karger Country of Publication: Switzerland NLM ID: 9610505 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1423-0143 (Electronic) Linking ISSN: 14204096 NLM ISO Abbreviation: Kidney Blood Press Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: Basel ; New York : Karger, c1996-
    • Subject Terms:
      Glomerulonephritis, Membranous*/pathology ; Glomerulonephritis, Membranous*/diagnosis ; Glomerulonephritis, IGA*/pathology ; Glomerulonephritis, IGA*/diagnosis ; Nephrosis, Lipoid*/pathology ; Kidney*/pathology ; Disease Progression*; Humans ; Male ; Female ; Middle Aged ; Adult ; Biopsy ; Prospective Studies ; Follow-Up Studies ; Proteinuria/etiology
    • Abstract:
      Introduction: This study evaluated the phenotypic and pathology characteristics of patients undergoing kidney biopsy at a single center, while also determining the frequency and factors associated with clinical outcomes.
      Methods: The incidence and distribution of biopsy-proven kidney diseases in 2000-2019 were surveyed. Consecutive individuals diagnosed with membranous nephropathy (MN), immunoglobulin A nephropathy (IgAN), and minimal change disease (MCD) between August 2015 and December 2019 were enrolled in the prospective 2-year follow-up study. Outcomes included remission of proteinuria and kidney disease progression events. Multivariable-adjusted Cox proportional hazards model was applied.
      Results: 4,550 kidney biopsies were performed in 2000-2019, showing a noticeable increase in the proportion of MN. 426 patients were enrolled in the follow-up cohort. 346 (81.2%) achieved remission of proteinuria, 39 (9.2%) suffered kidney disease progression and 51.3% of them were diagnosed with IgAN. Kidney pathological diagnosis (MN vs. MCD: hazard ratio [HR], 0.42; 95% confidence interval [95% CI], 0.31-0.57; IgAN vs. MCD: 0.58; 0.39-0.85), levels of 24-h urine protein at biopsy (1.04; 1.00-1.08) and presence of nodular mesangial sclerosis (0.70; 0.49-0.99) were significantly correlated with remission of proteinuria after adjusting for baseline variables. 24-h urine protein levels at biopsy (1.14; 1.04-1.25) and the presence of crescents (2.30; 1.06-4.95) were the independent risk factors for kidney disease progression events after adjusting for baseline variables.
      Conclusion: The increasing frequency of MN has been affirmed over the past 2 decades. The therapeutic status, clinical outcomes, and factors influencing these outcomes were presented in this single-center study for the three primary glomerular diseases.
      (© 2024 The Author(s). Published by S. Karger AG, Basel.)
    • Contributed Indexing:
      Keywords: End stage kidney disease; Glomerular filtration rate; Primary glomerulopathy; Proteinuria
    • Publication Date:
      Date Created: 20240414 Date Completed: 20240604 Latest Revision: 20240604
    • Publication Date:
      20240605
    • Accession Number:
      10.1159/000538851
    • Accession Number:
      38615671