Collapsing glomerulopathy- A troublemaker for the renal allograft: Lessons learnt
| Autor: | A V Vanikar, K.S. Suthar, Himanshu V Patel, H L Trivedi, Lovelesh Kumar Nigam, Rashmi D Patel, K. V. Kanodia |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
hypertension podocyte Urinalysis medicine.medical_treatment 030232 urology & nephrology Collapsing glomerulopathy 030230 surgery lcsh:RC870-923 Gastroenterology End stage renal disease 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Hypertensive Nephropathy medicine Microhematuria Creatinine Proteinuria end-stage renal disease medicine.diagnostic_test business.industry Immunosuppression lcsh:Diseases of the genitourinary system. Urology medicine.icd_9_cm_classification Surgery chemistry Nephrology Etiology Original Article medicine.symptom proteinuria business |
| Zdroj: | Indian Journal of Nephrology, Vol 27, Iss 5, Pp 342-346 (2017) Indian Journal of Nephrology |
| ISSN: | 1998-3662 0971-4065 |
| Popis: | Collapsing glomerulopathy (CG) is a well-recognized distinct morphological pattern of proliferative parenchymal injury leading to rapid graft failure. We conducted a single-center retrospective study to evaluate the prevalence, clinicopathological features, and prognosis of CG in renal transplant recepient. We analyzed 2518 renal allograft biopsies performed from 2007 to 2015 and correlated their clinicopathological features. The prevalence of CG was 0.83% (21 out of 2518) of allograft biopsies with a higher prevalence of 1.4% during the period from 2012 to 2015. Out of 21 patients, 18 (85.71%) patients had undergone live donor and 3 (14.28%) patients had undergone deceased donor renal transplant. Hypertension was observed in 3 (14.28%) patients. The mean duration of diagnosis for CG was 1.85 ± 1.91 years. Urinalysis revealed microhematuria in 5 (23.8%) patients. The mean 24 h urinary protein excretion was 4.77 ± 5.3 g and serum creatinine was 2.12 ± 1.5 mg/dl. The predominant native kidney diseases in recipients were chronic glomerulonephritis of unknown etiology in 12 (57.14%) patients and hypertensive nephropathy in 3 (14.28%) patients. CG was associated with rejection in 9 (42.85%), calcineurin-inhibitor toxicity in 2 (9.5%), and BK virus nephropathy in 1 patient. All patients received standard triple immunosuppression. Eleven (52.38%) patients developed graft failure over a mean period of 2.2 ± 1.7 years and 6 (28.57%) patients recovered with stable graft function. CG can coexist with viral infection, drug toxicity, rejection, microvascular injury, etc. CG usually presents with moderate to severe proteinuria and may lead to rapid graft dysfunction and subsequent graft failure in most of the patients. |
| Databáze: | OpenAIRE |
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