| Autor: |
Kovala, Marja, Seppälä, Minna, Wojnicki, Mikolaj, Honkanen, Eero, Meri, Seppo, Kaartinen, Kati, Räisänen-Sokolowski, Anne |
| Zdroj: |
Nephron; December 2024, Vol. 148 p734-743, 10p |
| Abstrakt: |
Introduction:Membranoproliferative glomerulonephritis is currently divided into immunoglobulin-mediated glomerulonephritis (IC-MPGN) and C3 glomerulopathy (C3G); however, the patients often overlap with histology, complement, clinical and prognostic factors. Our aim was to investigate if an unsupervised clustering method finds different patient groups in 44 IC-MPGN/C3G patients using only histological and clinical data available in everyday clinical work. Methods:Primary IC-MPGN/C3G adult patients were included whose diagnostic (baseline) native biopsy was obtained in 2006–2017. The biopsies were reassessed and the clinical data at baseline and during follow-up were obtained from the medical records. There were 39 baseline histological and clinical variables included in the unsupervised clustering. Follow-up information was combined with the clustering results. Results:The clustering resulted in two clusters (n= 24 and n= 20 patients for clusters 1–2, respectively), where cluster 1 had a significantly higher baseline plasma creatinine (mean 213 vs. 104, respectively, pvalue <0.001) and a lower baseline eGFR than cluster 2 (mean 37 vs. 70, respectively, pvalue <0.001). Regarding histology, chronic changes such as lobulated glomeruli, mesangial matrix expansion, and glomeruli double contours were more prevalent in cluster 1 (pvalue <0.001). Biopsy morphology was more often crescentic and membranoproliferative in cluster 1 (pvalue <0.001). Although the differences were insignificant, cluster 1 patients were in dialysis in the last follow-up or had a progressive disease more often than cluster 2 patients (21% vs. 5%, 38% vs. 10%). Conclusions:Our results indicate that these patients share greater similarity than the current classification IC-MPGN versus C3G indicates. |
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