A. Domingos, A. Braga, D. Gonçalves, S. Pedroso, L. Martins, J. Braga
If managing COVID-19 alone was a major challenge, one can expect an even greater challenge in certain scenarios, such as patients with kidney disease - including kidney transplant recipients (KT) – or pregnant women. When things could not get any worse, we just met the peculiar art of overcomplicating things: pregnant kidney and simultaneous kidney-pancreas (SKP) transplant recipients with COVID-19. Gleeson and colleagues (Imperial College, London) described the first similar case in April 2020. We describe two cases of pregnant KT and SKP transplant recipients with COVID-19, at different stages, and their evolution until delivery. Maternal and fetal outcomes are significantly affected by both KT and COVID-19, requiring a multidisciplinary approach with a well-trained team of obstetricians and nephrologists, as we will describe.
{"title":"Pregnant kidney transplant recipients with COVID-19; a report of two cases and literature review","authors":"A. Domingos, A. Braga, D. Gonçalves, S. Pedroso, L. Martins, J. Braga","doi":"10.34172/jnp.2022.17291","DOIUrl":"https://doi.org/10.34172/jnp.2022.17291","url":null,"abstract":"If managing COVID-19 alone was a major challenge, one can expect an even greater challenge in certain scenarios, such as patients with kidney disease - including kidney transplant recipients (KT) – or pregnant women. When things could not get any worse, we just met the peculiar art of overcomplicating things: pregnant kidney and simultaneous kidney-pancreas (SKP) transplant recipients with COVID-19. Gleeson and colleagues (Imperial College, London) described the first similar case in April 2020. We describe two cases of pregnant KT and SKP transplant recipients with COVID-19, at different stages, and their evolution until delivery. Maternal and fetal outcomes are significantly affected by both KT and COVID-19, requiring a multidisciplinary approach with a well-trained team of obstetricians and nephrologists, as we will describe.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43533078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
João Oliveira, I. Sala, Joana Freitas, J. Tavares, S. Santos, Andreia Campos, Josefina Santos Lascasas, T. Mendonça, A. Cabrita
{"title":"Refractory diffuse podocytopathy","authors":"João Oliveira, I. Sala, Joana Freitas, J. Tavares, S. Santos, Andreia Campos, Josefina Santos Lascasas, T. Mendonça, A. Cabrita","doi":"10.34172/jnp.2022.17314","DOIUrl":"https://doi.org/10.34172/jnp.2022.17314","url":null,"abstract":"<jats:p>\u0000 </jats:p>","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45606043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Costa, Anabela S Rodrigues, C. Ferreira, Carla Pereira Lima, Tânia, Couto Sousa, H. Viana, M. Góis, Sérgio Silva Lemos
Membranous nephropathy (MN) is a common cause of nephrotic syndrome (NS) in nondiabetic adults. Collapsing nephropathy (CN) is a morphological pattern that is usually classified as a variant of focal segmental glomerulosclerosis (cFSGS). The simultaneous presence of both MN and CN is rare and their combination usually foresees an unfavorable outcome. Herein, we describe a case report of a patient with PLA2 R-associated MN with collapse, its treatment and clinical course.
{"title":"Membranous nephropathy with collapse in a HIV negative patient; a case report with a 34-month follow-up","authors":"L. Costa, Anabela S Rodrigues, C. Ferreira, Carla Pereira Lima, Tânia, Couto Sousa, H. Viana, M. Góis, Sérgio Silva Lemos","doi":"10.34172/jnp.2022.17337","DOIUrl":"https://doi.org/10.34172/jnp.2022.17337","url":null,"abstract":"Membranous nephropathy (MN) is a common cause of nephrotic syndrome (NS) in nondiabetic adults. Collapsing nephropathy (CN) is a morphological pattern that is usually classified as a variant of focal segmental glomerulosclerosis (cFSGS). The simultaneous presence of both MN and CN is rare and their combination usually foresees an unfavorable outcome. Herein, we describe a case report of a patient with PLA2 R-associated MN with collapse, its treatment and clinical course.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45549713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Jayaprakash, Muthukaruppaiah Suganya, Dhanasekaran Karthick, A. Kurien, Raghavan Padmanabhan
Severe rhabdomyolysis could lead to myoglobinuria and acute kidney injury (AKI). Acute interstitial nephritis (AIN) is commonly caused by drugs. AIN per se can cause ‘severe’ AKI. Renal recovery is delayed when several factors are involved in the pathogenesis of AKI. Survivors of AKI require long-term follow-up. Here, we report a case where both severe rhabdomyolysis and drug-induced AIN contributed to ‘severe’ dialysis-requiring AKI. Renal biopsy was diagnostic and showed characteristic features. Steroid therapy for AIN resulted in partial recovery.
{"title":"\"Double whammy\" to the kidneys: an unusual etiology of acute kidney disease","authors":"V. Jayaprakash, Muthukaruppaiah Suganya, Dhanasekaran Karthick, A. Kurien, Raghavan Padmanabhan","doi":"10.34172/jnp.2022.17252","DOIUrl":"https://doi.org/10.34172/jnp.2022.17252","url":null,"abstract":"Severe rhabdomyolysis could lead to myoglobinuria and acute kidney injury (AKI). Acute interstitial nephritis (AIN) is commonly caused by drugs. AIN per se can cause ‘severe’ AKI. Renal recovery is delayed when several factors are involved in the pathogenesis of AKI. Survivors of AKI require long-term follow-up. Here, we report a case where both severe rhabdomyolysis and drug-induced AIN contributed to ‘severe’ dialysis-requiring AKI. Renal biopsy was diagnostic and showed characteristic features. Steroid therapy for AIN resulted in partial recovery.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49579434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammadreza Rahimi Majd, Maliheh Yarmohamadi, M. Parvin, Soheila Mirjan
Here, we present a 74-year-old man with acute kidney injury (AKI) due to diazinon 60% (accidental poisoning) which was successfully treated by hemodialysis.’
{"title":"An unusual cause of acute kidney injury \"inhalation of diazinon\"","authors":"Mohammadreza Rahimi Majd, Maliheh Yarmohamadi, M. Parvin, Soheila Mirjan","doi":"10.34172/jnp.2022.17227","DOIUrl":"https://doi.org/10.34172/jnp.2022.17227","url":null,"abstract":"Here, we present a 74-year-old man with acute kidney injury (AKI) due to diazinon 60% (accidental poisoning) which was successfully treated by hemodialysis.’","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46600850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elham Emami, A. Hasanpour Dehkordi, A. Maghsoudi, H. Nasri, Alireza Vahedi
Introduction: Gentamicin, despite its beneficial effects, has significant nephrotoxic effects that are observed in 20% of the patients. Ezetimibe is recognized as an inhibitor of cholesterol absorption. Objectives: The present study aimed to investigate the histopathological effects of ezetimibe on gentamicin-induced kidney damage. Material and Methods: Twenty male Wistar rats were randomly divided into five groups and treated as the following; group 1 (normal group), group 2 [gentamicin group, daily 80 mg/kg, intraperitoneal (i.p.) for seven days], group 3-5 (gentamicin 80 + ezetimibe at doses of 2.5, 12.5, and 37.5 mg/kg, respectively). Kidney sections were examined for histopathological parameters including vacuolization of the tubular renal cells, degeneration, necrosis, flattening of the tubular cells and debris in the tubular lumen. Results: Gentamicin injection significantly induced histopathological alterations (P< 0.05). Ezetimibe therapy significantly decreased the levels of vacuolization, degeneration, necrosis, flattening of the tubular cells and debris in the nephrotoxic rats (P< 0.05). Conclusion: The results illustrated that treatment with ezetimibe can improve kidney damage caused by gentamicin injection.
{"title":"Ameliorative impact of ezetimibe on gentamicin-induced kidney damage; A histopathological perspective","authors":"Elham Emami, A. Hasanpour Dehkordi, A. Maghsoudi, H. Nasri, Alireza Vahedi","doi":"10.34172/jnp.2022.17341","DOIUrl":"https://doi.org/10.34172/jnp.2022.17341","url":null,"abstract":"\u0000 Introduction: Gentamicin, despite its beneficial effects, has significant nephrotoxic effects that are observed in 20% of the patients. Ezetimibe is recognized as an inhibitor of cholesterol absorption. Objectives: The present study aimed to investigate the histopathological effects of ezetimibe on gentamicin-induced kidney damage. Material and Methods: Twenty male Wistar rats were randomly divided into five groups and treated as the following; group 1 (normal group), group 2 [gentamicin group, daily 80 mg/kg, intraperitoneal (i.p.) for seven days], group 3-5 (gentamicin 80 + ezetimibe at doses of 2.5, 12.5, and 37.5 mg/kg, respectively). Kidney sections were examined for histopathological parameters including vacuolization of the tubular renal cells, degeneration, necrosis, flattening of the tubular cells and debris in the tubular lumen. Results: Gentamicin injection significantly induced histopathological alterations (P< 0.05). Ezetimibe therapy significantly decreased the levels of vacuolization, degeneration, necrosis, flattening of the tubular cells and debris in the nephrotoxic rats (P< 0.05). Conclusion: The results illustrated that treatment with ezetimibe can improve kidney damage caused by gentamicin injection.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46249980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Hamza, Ahmed Fayed, A. Shaker, M. E. El Nokeety
Introduction: Medical renal diseases stand as one of the major health problems in pediatric age group considering its morbidity/mortality and the subsequent management plans. Objectives: In this manuscript, the spectrum of histopathological patterns of medical nephropathic lesions in Egyptian pediatric patients over duration of five years is reported with clinical indications. Patients and Methods: We conducted a retrospective study for analysis of our pathological reports of renal needle biopsies during the period from January 2014 until January 2019. One hundred and sixteen cases were included. Results: The most commonly encountered pediatric renal pathology was minimal change disease (27.59%), followed by congenital glomerular diseases (22.41%), focal segmental glomerulosclerosis (12.93%), and thrombotic microangiopathy (7.76%). The most common clinical indication for biopsy was nephrotic syndrome (37.07%) followed by impaired renal functions with elevated serum creatinine (21.55%). In addition, we report very rare histological findings in few cases including infantile nephropathic cystinosis, Barakat syndrome and C3 glomerulopathy. Conclusion: Minimal change disease and congenital glomerular diseases accounted for half of pediatric renal pathologies in the study population. The most common clinical indication for renal biopsy was nephrotic syndrome. Electron microscopic examination and genetic studies are mandatory for proper evaluation of pediatric nephropathies.
{"title":"Spectrum of histopathological findings in pediatric renal biopsies; a five-year single center experience in Egypt","authors":"W. Hamza, Ahmed Fayed, A. Shaker, M. E. El Nokeety","doi":"10.34172/jnp.2022.17247","DOIUrl":"https://doi.org/10.34172/jnp.2022.17247","url":null,"abstract":"Introduction: Medical renal diseases stand as one of the major health problems in pediatric age group considering its morbidity/mortality and the subsequent management plans. Objectives: In this manuscript, the spectrum of histopathological patterns of medical nephropathic lesions in Egyptian pediatric patients over duration of five years is reported with clinical indications. Patients and Methods: We conducted a retrospective study for analysis of our pathological reports of renal needle biopsies during the period from January 2014 until January 2019. One hundred and sixteen cases were included. Results: The most commonly encountered pediatric renal pathology was minimal change disease (27.59%), followed by congenital glomerular diseases (22.41%), focal segmental glomerulosclerosis (12.93%), and thrombotic microangiopathy (7.76%). The most common clinical indication for biopsy was nephrotic syndrome (37.07%) followed by impaired renal functions with elevated serum creatinine (21.55%). In addition, we report very rare histological findings in few cases including infantile nephropathic cystinosis, Barakat syndrome and C3 glomerulopathy. Conclusion: Minimal change disease and congenital glomerular diseases accounted for half of pediatric renal pathologies in the study population. The most common clinical indication for renal biopsy was nephrotic syndrome. Electron microscopic examination and genetic studies are mandatory for proper evaluation of pediatric nephropathies.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43103463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Acute kidney injury (AKI) and sepsis are significant causes of morbidity and mortality in intensive care units. Therefore, early screening of high-risk individuals is critical for preventing AKI and improving outcomes. Objectives: To examine the possible involvement of uric acid in predicting AKI and mortality in septic patients. Patients and Methods: A prospective study recruited 400 patients with sepsis based on the quick Sequential Organ Failure Assessment (qSOFA) criteria who were hospitalized in the intensive care unit (ICU). Patients were categorized into two groups depending on their uric acid levels; those with a serum uric acid ≥7 mg/dL and those with a serum uric acid <7 mg/dL. Results: A total of 400 septic patients were included in this study. Among them, 52.5% (210/400) patients had hyperuricemia during admission to the ICU. A total of 177/400 (44.2%) patients developed AKI. The likelihood of having hyperuricemia in association with AKI was 65.6%. Meanwhile, the likelihood of having a uric acid level of less than 7 mg/dL in association with AKI was 23.9% (P<0.001). The mortality rate in the hyperuricemia group was substantially greater than in the normal uric acid level group (P<0.001). Uric acid levels higher than 7 mg/dL were significantly associated with AKI by multivariate logistic regression (P= 0.002). Receiver operating characteristic (ROC) curves revealed that uric acid has a high predictive value for AKI and ICU mortality in patients with sepsis. Conclusion: Serum uric acid could be a marker to predict AKI and mortality in patients with sepsis.
{"title":"The predictive value of serum uric acid in development of acute kidney injury and mortality in patients with sepsis","authors":"Doaa Atef Moubarez","doi":"10.34172/jnp.2022.17307","DOIUrl":"https://doi.org/10.34172/jnp.2022.17307","url":null,"abstract":"\u0000 Introduction: Acute kidney injury (AKI) and sepsis are significant causes of morbidity and mortality in intensive care units. Therefore, early screening of high-risk individuals is critical for preventing AKI and improving outcomes. Objectives: To examine the possible involvement of uric acid in predicting AKI and mortality in septic patients. Patients and Methods: A prospective study recruited 400 patients with sepsis based on the quick Sequential Organ Failure Assessment (qSOFA) criteria who were hospitalized in the intensive care unit (ICU). Patients were categorized into two groups depending on their uric acid levels; those with a serum uric acid ≥7 mg/dL and those with a serum uric acid <7 mg/dL. Results: A total of 400 septic patients were included in this study. Among them, 52.5% (210/400) patients had hyperuricemia during admission to the ICU. A total of 177/400 (44.2%) patients developed AKI. The likelihood of having hyperuricemia in association with AKI was 65.6%. Meanwhile, the likelihood of having a uric acid level of less than 7 mg/dL in association with AKI was 23.9% (P<0.001). The mortality rate in the hyperuricemia group was substantially greater than in the normal uric acid level group (P<0.001). Uric acid levels higher than 7 mg/dL were significantly associated with AKI by multivariate logistic regression (P= 0.002). Receiver operating characteristic (ROC) curves revealed that uric acid has a high predictive value for AKI and ICU mortality in patients with sepsis. Conclusion: Serum uric acid could be a marker to predict AKI and mortality in patients with sepsis.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49197432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Kottangal, S. V. Nalumakkal, Smitha Nalumakkal Vijayan
Human adenovirus is a linear, non-enveloped, double-stranded DNA virus that can cause opportunistic infections. Typically, adenovirus infections result in self-limiting respiratory, gastrointestinal or ocular infections. However, it can cause severe disseminated disease in immunocompromised patients, especially in post-transplant recipients. In kidney transplant recipients, adenovirus infections have an incidence of up to 4.1%, usually manifested as hemorrhagic cystitis and tubulointerstitial nephritis, in the first three months post-transplant. Renal biopsy shows necrotizing granulomatous interstitial nephritis and other features consistent with the viral infection. Investigations like immunohistochemistry and polymerase chain reaction (PCR) help in confirmation of the diagnosis. Resolution of the disease with the reduction in immunotherapy alone supports the role of immunosuppression as a risk factor for adenovirus infection.
{"title":"A rare case of adenovirus infection in post renal transplant patient","authors":"G. Kottangal, S. V. Nalumakkal, Smitha Nalumakkal Vijayan","doi":"10.34172/jnp.2022.17226","DOIUrl":"https://doi.org/10.34172/jnp.2022.17226","url":null,"abstract":"Human adenovirus is a linear, non-enveloped, double-stranded DNA virus that can cause opportunistic infections. Typically, adenovirus infections result in self-limiting respiratory, gastrointestinal or ocular infections. However, it can cause severe disseminated disease in immunocompromised patients, especially in post-transplant recipients. In kidney transplant recipients, adenovirus infections have an incidence of up to 4.1%, usually manifested as hemorrhagic cystitis and tubulointerstitial nephritis, in the first three months post-transplant. Renal biopsy shows necrotizing granulomatous interstitial nephritis and other features consistent with the viral infection. Investigations like immunohistochemistry and polymerase chain reaction (PCR) help in confirmation of the diagnosis. Resolution of the disease with the reduction in immunotherapy alone supports the role of immunosuppression as a risk factor for adenovirus infection.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43389308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdul-Jalil Inusah, L. Coetzee, W. Bates, M. Chothia
Introduction: HIV-associated kidney diseases continue to be a major problem in South Africa. Objectives: We aimed to determine the kidney outcomes of immune-complex associated mesangiocapillary glomerulonephritis (MCGN) in patients with and without HIV. Patients and Methods: A retrospective cohort study was conducted on all adult patients with a kidney biopsy diagnosis of immune-complex associated MCGN from 1 January 2000 to 31 December 2016. We compared the proportion of HIV-positive and HIV-negative patients that reached the composite endpoint of either doubling of the serum creatinine or end-stage kidney disease. Cox proportional hazards models were employed to examine the association between the composite endpoint and predictor variables. Results: A total of 79 patients were included of which 20 (25.3%) were HIV-positive. Twentyfour patients (30.4%) reached the composite endpoint. The cumulative proportions reaching the composite endpoint at one and four years were 25.3% and 30.4% with no difference between HIVpositive and HIV-negative patients (45.0% versus 25.4%, respectively; P= 0.10). Multivariable Cox proportional hazards model identified estimated glomerular filtration rate at biopsy (hazard ratio [HR] = 0.92; 95% confidence interval [CI]: 0.84-1.00, P=0.04) and proteinuria at follow-up (HR = 1.60; 95% CI: 1.21-2.11, P<0.01) as predictors of the composite endpoint at one-year. On survival analysis, there was no difference in the composite endpoint for HIV status (P=0.09; log-rank). Conclusion: Immune-complex associated MCGN continues to be a common histopathological pattern of injury at our center. Due to late presentation, kidney outcomes remain poor, regardless of HIV status.
{"title":"Kidney outcomes of immune-complex associated mesangiocapillary glomerulonephritis in patients with and without HIV","authors":"Abdul-Jalil Inusah, L. Coetzee, W. Bates, M. Chothia","doi":"10.34172/jnp.2022.17269","DOIUrl":"https://doi.org/10.34172/jnp.2022.17269","url":null,"abstract":"Introduction: HIV-associated kidney diseases continue to be a major problem in South Africa. Objectives: We aimed to determine the kidney outcomes of immune-complex associated mesangiocapillary glomerulonephritis (MCGN) in patients with and without HIV. Patients and Methods: A retrospective cohort study was conducted on all adult patients with a kidney biopsy diagnosis of immune-complex associated MCGN from 1 January 2000 to 31 December 2016. We compared the proportion of HIV-positive and HIV-negative patients that reached the composite endpoint of either doubling of the serum creatinine or end-stage kidney disease. Cox proportional hazards models were employed to examine the association between the composite endpoint and predictor variables. Results: A total of 79 patients were included of which 20 (25.3%) were HIV-positive. Twentyfour patients (30.4%) reached the composite endpoint. The cumulative proportions reaching the composite endpoint at one and four years were 25.3% and 30.4% with no difference between HIVpositive and HIV-negative patients (45.0% versus 25.4%, respectively; P= 0.10). Multivariable Cox proportional hazards model identified estimated glomerular filtration rate at biopsy (hazard ratio [HR] = 0.92; 95% confidence interval [CI]: 0.84-1.00, P=0.04) and proteinuria at follow-up (HR = 1.60; 95% CI: 1.21-2.11, P<0.01) as predictors of the composite endpoint at one-year. On survival analysis, there was no difference in the composite endpoint for HIV status (P=0.09; log-rank). Conclusion: Immune-complex associated MCGN continues to be a common histopathological pattern of injury at our center. Due to late presentation, kidney outcomes remain poor, regardless of HIV status.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44185818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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