Document Detail


Clinical outcomes and predictors for ESRD and mortality in primary GN.
MedLine Citation:
PMID:  22798538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Relatively little is known about the long-term outcomes of different histologic types of primary glomerulonephritis in Asian populations.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: From 1993 to 2006, 987 patients undergoing renal biopsy were studied, and 580 patients (mean age=44.4 years, male=58.5%) with the four most common forms of glomerulonephritis (membranous nephropathy, focal and segmental glomerulosclerosis, IgA nephropathy, and minimal change disease) were selected for analysis. Median follow-up period was 5.9 (interquartile range=5.7) years.
RESULTS: The focal and segmental glomerulosclerosis group displayed the highest incidence of ESRD (25.8%) and the fastest decline of estimated GFR (4.6 ml/min per 1.73 m(2) per year). The IgA nephropathy group also had a higher rate of ESRD than the membranous nephropathy patients (19.2% versus 4.3%, P<0.001). In contrast, the membranous nephropathy group exhibited an overall death rate similar to the focal and segmental glomerulosclerosis group (17.2% versus 14.4%) but higher than the IgA nephropathy and minimal change disease patients (4.6% and 3.7%, respectively, P<0.001). The most powerful predictor for ESRD was focal and segmental glomerulosclerosis, whereas the strongest predictor for all-cause mortality was membranous nephropathy with higher proteinuria. Protectors against ESRD included male sex and higher hemoglobin.
CONCLUSIONS: Most predictors for ESRD and overall mortality found in this ethnic Chinese cohort were similar to other studies. However, some risk factors linked with distinct glomerular pathologies displayed differential clinical outcomes.
Authors:
Yu-Hsiang Chou; Yu-Chung Lien; Fu-Chang Hu; Wei-Chou Lin; Chih-Chin Kao; Chun-Fu Lai; Wen-Chih Chiang; Shuei-Liong Lin; Tun-Jun Tsai; Kwan-Dun Wu; Yung-Ming Chen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-12
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  7     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-10     Completed Date:  2013-01-29     Revised Date:  2013-09-10    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1401-8     Citation Subset:  IM    
Affiliation:
Renal Division, Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yunlin County, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Asian Continental Ancestry Group
Biological Markers / blood
Biopsy
Chi-Square Distribution
Disease Progression
Female
Glomerulonephritis / blood,  ethnology,  mortality*,  pathology,  therapy
Glomerulonephritis, IGA / mortality,  pathology
Glomerulonephritis, Membranous / mortality,  pathology
Glomerulosclerosis, Focal Segmental / mortality,  pathology
Hemoglobins / metabolism
Humans
Incidence
Kaplan-Meier Estimate
Kidney / pathology
Kidney Failure, Chronic / blood,  ethnology,  mortality*,  pathology,  therapy
Male
Middle Aged
Multivariate Analysis
Nephrosis, Lipoid / mortality,  pathology
Prognosis
Proportional Hazards Models
Proteinuria / mortality
Renal Dialysis
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Taiwan / epidemiology
Time Factors
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Hemoglobins
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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