Persistent Disease Activity in Patients With Long-Standing Glomerular Disease.

Autor:	Delbarba E; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA.; Division of Nephrology, Spedali Civili and University of Brescia, Brescia, Italy., Marasa M; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA., Canetta PA; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA., Piva SE; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA., Chatterjee D; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA., Kil BH; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA., Mu X; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA., Gibson KL; Division of Nephrology, Department of Pediatrics, North Carolina Children's Hospital, Chapel Hill, North Carolina, USA., Hladunewich MA; Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Hogan JJ; Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Julian BA; Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA., Kidd JM; Division of Nephrology, Virginia Commonwealth University, Richmond, Virginia, USA., Laurin LP; Division of Nephrology, Maisonneuve-Rosemont Hospital, Department of Medicine, University of Montreal, Montreal, Quebec, Canada., Nachman PH; Department of Medicine, Division of Renal Diseases and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Rheault MN; Division of Nephrology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA., Rizk DV; Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA., Sanghani NS; Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Trachtman H; Division of Nephrology, Department of Medicine and Pediatrics, New York University Langone Health and New York University School of Medicine, New York, New York, USA., Wenderfer SE; Renal Section, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Gharavi AG; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA., Bomback AS; Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Jazyk:	angličtina
Zdroj:	Kidney international reports [Kidney Int Rep] 2020 Mar 20; Vol. 5 (6), pp. 860-871. Date of Electronic Publication: 2020 Mar 20 (Print Publication: 2020).
DOI:	10.1016/j.ekir.2020.03.017
Abstrakt:	Introduction: Glomerular diseases are characterized by variable disease activity over many years. We aimed to analyze the relationship between clinical disease activity and duration of glomerular disease. Methods: Disease activity in adults with chronic minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and IgA nephropathy (IgAN; first diagnostic biopsy >5 years before enrollment; Of Longstanding Disease [OLD] cohort, n  = 256) followed at Columbia University Medical Center (CUMC), was compared with disease activity of an internal and external cohort of patients with first diagnostic biopsy <5 years before enrollment drawn from the Cure Glomerulonephropathy Network (CureGN cohort, n  = 1182; CUMC-CureGN cohort, n  = 362). Disease activity was defined by (i) Kidney Disease: Improving Global Outcomes-recommended threshold criteria for initiation of immunosuppression in primary glomerulonephropathy (GN) and (ii) CureGN's Disease Activity Working Group definitions for activity. Results: No significant differences were detected among the 3 cohorts in terms of age, sex, serum creatinine, and urinary protein-to-creatinine ratio. For each GN subtype, disease activity in the OLD cohort was comparable with disease activity in the entire CureGN and the CUMC-CureGN cohort. When limiting our comparisons to disease activity in incident CUMC-CureGN patients (first diagnostic biopsy within 6 months of enrollment), OLD patients demonstrated similar activity rates as incident patients. Conclusion: Disease activity did not differ among patients with shorter versus longer duration of disease. Such survivor patients, with long-term but persistent disease, are potentially highly informative for understanding the clinical course and pathogenesis of GN and may help identify factors mediating more chronic subtypes of disease. (© 2020 International Society of Nephrology. Published by Elsevier Inc.)
Databáze:	MEDLINE
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