Focal segmental glomerulosclerosis in IgA nephropathy with regard to Oxford classification: Does it matter?

• Autor(a) principal: Nasri,Hamid
• Data de Publicação: 2014
• Outros Autores: Mubarak,Muhammed
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692014000300004
• topic: Columbia classification focal segmental glomerulosclerosis; IgA nephropathy; Oxford classification; proteinuria; renal failure

Background: The lesions resembling focal segmental glomerulosclerosis (FSGS) are frequently found concurrently with IgA nephropathy (IgAN). However, there is controversy regarding the significance of this co -existence. In this study, we sought to determine the significance of FSGS-like lesions in a group of IgAN patients, especially with regard to the Oxford classification. Patients and Methods: The FSGS lesions were typed according to the Columbia classification and correlated with clinico -pathological parameters including Oxford classification criteria. Individual lesions suggesting FSGS were also evaluated. IgAN lesions were classified according to the Oxford classification. Results: Of 114 patients, 80 (70.2 %) were male. The mean age of patients was 37.7 ± 13.6 years. Of 35 patients with co-existent IgAN and FSGS, 50% had classic variant (not otherwise specified; NOS), 30% had tip and 20% perihilar variant of FSGS. None of the patients had collapsing or cellular variants. A significantly positive association of FSGS with M (p = 0.001), S (p = 0.001) and T p = 0.001) variables of Oxford classification was found. No significant difference of FSGS, hyalinosis, capsular adhesions and podocytopathy was found between males and females (p > 0.05). However, a significantly positive association of proteinuria (p = 0.037) and renal dysfunction (p = 0.026) with podocytopathy, and of serum creatinine and renal dysfunction with the presence of FSGS (p = 0.027, p = 0.001, respectively) was seen. Conclusion: In conclusion, the concurrence of FSGS -like lesions with IgAN is associated with the established poor clinical and pathological prognostic factors of this disease and the lesions appear to be of prognostic significance. The presence of such lesions should be sought diligently on renal biopsy examination.