|Clinical outcomes and predictors for ESRD and mortality in primary GN.|
|PMID: 22798538 Owner: NLM Status: MEDLINE|
|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.
|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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|Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2012-07-12|
|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|
|Created Date: 2012-09-10 Completed Date: 2013-01-29 Revised Date: 2013-04-16|
Medline Journal Info:
|Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States|
|Languages: eng Pagination: 1401-8 Citation Subset: IM|
|Renal Division, Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yunlin County, Taiwan.|
|APA/MLA Format Download EndNote Download BibTex|
Asian Continental Ancestry Group
Biological Markers / blood
Glomerulonephritis / blood, ethnology, mortality*, pathology, therapy
Glomerulonephritis, IGA / mortality, pathology
Glomerulonephritis, Membranous / mortality, pathology
Glomerulosclerosis, Focal Segmental / mortality, pathology
Hemoglobins / metabolism
Kidney / pathology
Kidney Failure, Chronic / blood, ethnology, mortality*, pathology, therapy
Nephrosis, Lipoid / mortality, pathology
Proportional Hazards Models
Proteinuria / mortality
Taiwan / epidemiology
|0/Biological Markers; 0/Hemoglobins|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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