Clinicopathological correlations in proteinuric diseases: presenting features of patients with minimal change disease, focal and segmental glomerulosclerosis and membranous nephropathy

• Autor(a) principal: Neves,Marta
• Data de Publicação: 2014
• Outros Autores: Rodrigues,Luis, Sa,Helena, Pratas,Jorge, Campos,Maria
• 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=S0872-01692014000300006
• topic: Focal and segmental glomerulosclerosis; membranous nephropathy; minimal change disease; proteinuria

Background: Some clinical and laboratory features may provide clues to the diagnosis of specific glomerular diseases. However, the kidney biopsy remains the gold standard in the diagnosis of parenchymal disease. Aim: To compare presenting clinical and laboratory features and report outcomes of adult patients with proteinuria diagnosed with primary minimal change disease (MCD), focal and segmental glomerulosclerosis (FSGS), and membranous nephropathy (MN). Subjects and Methods: Retrospective study of 143 patients over the age of eighteen years diagnosed with primary MCD, FSGS or MN, between 1981 and 2009. The groups were compared regarding presenting features and outcomes. Results: The most common glomerulopathy was MN (49.7%), followed by MCD (25.2%) and FSGS (25.2%). Statistically significant differences (p < 0.05) were found between the three groups regarding proteinuria, serum albumin, total cholesterol and serum creatinine higher than 1.5 mg/dl at the time of kidney biopsy, as well as the motive for the biopsy. No statistical differences were found between the three histological groups regarding remission at the end of the follow-up. Statistically significant differences (p < 0.05) were determined between the three groups regarding time to partial and complete remission, proteinuria and serum albumin at the final evaluation, and infectious complications. Conclusions: Patients with MCD presented lower serum albumin and higher levels of 24 -hour proteinuria and total cholesterol than the other groups. Patients with MCD achieved remission sooner, but suffered more infectious complications than those with FSGS or MN. In turn, patients with FSGS had higher proteinuria at the final evaluation and a trend towards the need for long-term RRT.