Evidence from the Oxford Classification cohort supports the clinical value of subclassification of focal segmental glomerulosclerosis in IgA nephropathy
| Autor: | Rosanna Coppo, Francesco Emma, François Berthoux, Kensuke Joh, Haiyan Wang, Daniel C. Cattran, Giuseppe D'Amico, F. Paolo Schena, Franco Ferrario, Olga Vorobyeva, Shubha Bellur, Fernand Mac-Moune Lai, N Yoshikawa, Stéphan Troyanov, Alessandro Amore, Vivette D. D'Agati, Jan J. Weening, Stephen I-Hong Hsu, Charles E. Alpers, Jonathan Barratt, J. Charles Jennette, Fanny Lepeytre, Fernando C. Fervenza, John Feehally, Sandrine Florquin, Agnes B. Fogo, Tetsuya Kawamura, Bruce Mackinnon, H. Terence Cook, Hong Zhang, Zhihong Liu, Philip Kam-Tao Li, Mark Haas, Jan A. Bruijn, Colin C. Geddes, Ian Roberts, Ronald J. Hogg, Hermann-Josef Groene, Lei-Shi Li, Prue Hill, Steven N. Emancipator, Andrew M. Herzenberg, Yasuhiko Tomino, Sergio Mezzano, Stephen M. Bonsib, Bruce A. Julian, Patrick D. Walker |
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| Přispěvatelé: | Pathology |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pathology Biopsy medicine.medical_treatment 030232 urology & nephrology Kaplan-Meier Estimate VARIANTS 030204 cardiovascular system & hematology urologic and male genital diseases podocytopathy Podocyte Muscle hypertrophy 0302 clinical medicine Focal segmental glomerulosclerosis Child Proteinuria medicine.diagnostic_test PODOCYTE Glomerulosclerosis Focal Segmental Podocytes Immunosuppression IgA nephropathy Urology & Nephrology Middle Aged Prognosis medicine.anatomical_structure Nephrology TRIAL Female medicine.symptom Life Sciences & Biomedicine Glomerular Filtration Rate Adult medicine.medical_specialty Adolescent segmental sclerosis Renal function Nephropathy Young Adult 03 medical and health sciences medicine Humans Retrospective Studies Immunosuppression Therapy Science & Technology business.industry Reproducibility of Results 1103 Clinical Sciences Glomerulonephritis IGA Hypertrophy medicine.disease business Follow-Up Studies |
| Zdroj: | Kidney international, 91(1), 235-243. Nature Publishing Group |
| ISSN: | 0085-2538 |
| Popis: | Focal segmental glomerulosclerosis (FSGS) is a common finding in IgA nephropathy (IgAN). Here we assessed FSGS lesions in the Oxford Classification patient cohort and correlated histology with clinical presentation and outcome to determine whether subclassification of the S score in IgAN is reproducible and of clinical value. Our subclassification of lesions in 137 individuals with segmental glomerulosclerosis or adhesion (S1) identified 38% with podocyte hypertrophy, 10% with hyalinosis, 9% with resorption droplets within podocytes, 7% with tip lesions, 3% with perihilar sclerosis, and 2% with endocapillary foam cells. Reproducibility was good or excellent for tip lesions, hyalinosis, and perihilar sclerosis; moderate for podocyte hypertrophy; and poor for resorption droplets, adhesion only, and endocapillary foam cells. Podocyte hypertrophy and tip lesions were strongly associated with greater initial proteinuria. During follow-up of patients without immunosuppression, those with these features had more rapid renal function decline and worse survival from a combined event compared to S1 patients without such features and those without FSGS. Also in individuals with podocyte hypertrophy or tip lesions, immunosuppressive therapy was associated with better renal survival. In IgA nephropathy, the presence of podocyte hypertrophy or tip lesions, markers of podocyte injury, were reproducible. These features are strongly associated with proteinuria and, in untreated patients, carry a worse prognosis. Thus, our findings support reporting podocytopathic features alongside the S score of the Oxford Classification. |
| Databáze: | OpenAIRE |
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