In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 9 ( 2022-9-2), p. e0273671-
Abstract:
In nephrotic range proteinuria of adult-onset, kidney biopsy is the diagnostic gold standard in determining the underlying cause of disease. However, in low grade or subnephrotic proteinuria the diagnostic value of kidney biopsy as first-line diagnostics is less well established. Methods We conducted a retrospective analysis of all native kidney biopsies at our institution (n = 639) between 01/2012 and 05/2021 for comparison of histological diagnoses and clinical outcomes stratified by amount of proteinuria at the time of kidney biopsy: A: 〈 300mg/g creatinine (low grade), B: 300-3500mg/g creatinine (subnephrotic), C 〉 3500mg/g creatinine (nephrotic). Results Nephrotic range proteinuria was associated with the highest frequency (49.3%) of primary glomerulopathies followed by subnephrotic (34.4%) and low grade proteinuria (37.7%). However, within the subnephrotic group, the amount of proteinuria at kidney biopsy was linearly associated with renal and overall survival (HR 1.05 per Δ100mg protein/g creatinine (95% CI: 1.02–1.09, p = 0.001)) independent of present histological diagnoses and erythrocyturia. Conclusion Frequency of primary glomerulopathies supports to perform kidney biopsy in patients with subnephrotic proteinuria. These patients have a substantial risk of ESKD and death upon follow-up. Therefore, diagnostic accuracy including histopathology is essential to guide personalized treatment and avert detrimental courses.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0273671
DOI:
10.1371/journal.pone.0273671.g001
DOI:
10.1371/journal.pone.0273671.g002
DOI:
10.1371/journal.pone.0273671.g003
DOI:
10.1371/journal.pone.0273671.t001
DOI:
10.1371/journal.pone.0273671.t002
DOI:
10.1371/journal.pone.0273671.t003
DOI:
10.1371/journal.pone.0273671.t004
DOI:
10.1371/journal.pone.0273671.s001
DOI:
10.1371/journal.pone.0273671.s002
DOI:
10.1371/journal.pone.0273671.s003
DOI:
10.1371/journal.pone.0273671.s004
DOI:
10.1371/journal.pone.0273671.r001
DOI:
10.1371/journal.pone.0273671.r002
DOI:
10.1371/journal.pone.0273671.r003
DOI:
10.1371/journal.pone.0273671.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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