In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 7 ( 2023-7-20), p. e0288384-
Kurzfassung:
A subset of IgA nephropathy (IgAN) patients exhibiting minimal change disease (MCD) like features present with nephrotic-range proteinuria and warrants immunosuppressive therapy (IST). However, the diagnosis of MCD-like IgAN varied by reports. We aimed to identify the key pathological features of MCD-like IgAN. Methods In this cohort, 228 patients had biopsy-proven IgAN from 2009 to 2021, of which 44 without segmental sclerosis were enrolled. Patients were classified into segmental ( 〈 50% glomerular capillary loop involvement) or global ( 〉 50%) foot process effacement (FPE) groups. We further stratified them according to the usage of immunosuppressant therapy after biopsy. Clinical manifestations, treatment response, and renal outcome were compared. Results 26 cases (59.1%) were classified as segmental FPE group and 18 cases (40.9%) as global FPE group. The global FPE group had more severe proteinuria (11.48 [2.60, 15.29] vs. 0.97 [0.14, 1.67] g/g, p = 0.001) and had a higher proportion of complete remission (81.8% vs. 20%, p = 0.018). In the global FPE group, patients without IST experienced more rapid downward eGFR change than the IST-treated population (-0.38 [-1.24, 0.06] vs. 1.26 [-0.17, 3.20] mL/min/1.73 m 2 /month, p = 0.004). Conclusions The absence of segmental sclerosis and the presence of global FPE are valuable pathological features that assist in identifying MCD-like IgAN.
Materialart:
Online-Ressource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0288384
DOI:
10.1371/journal.pone.0288384.g001
DOI:
10.1371/journal.pone.0288384.g002
DOI:
10.1371/journal.pone.0288384.g003
DOI:
10.1371/journal.pone.0288384.g004
DOI:
10.1371/journal.pone.0288384.t001
DOI:
10.1371/journal.pone.0288384.t002
DOI:
10.1371/journal.pone.0288384.t003
DOI:
10.1371/journal.pone.0288384.t004
DOI:
10.1371/journal.pone.0288384.s001
DOI:
10.1371/journal.pone.0288384.s002
DOI:
10.1371/journal.pone.0288384.s003
DOI:
10.1371/journal.pone.0288384.s004
DOI:
10.1371/journal.pone.0288384.s005
DOI:
10.1371/journal.pone.0288384.s006
DOI:
10.1371/journal.pone.0288384.s007
DOI:
10.1371/journal.pone.0288384.r001
DOI:
10.1371/journal.pone.0288384.r002
DOI:
10.1371/journal.pone.0288384.r003
DOI:
10.1371/journal.pone.0288384.r004
DOI:
10.1371/journal.pone.0288384.r005
DOI:
10.1371/journal.pone.0288384.r006
Sprache:
Englisch
Verlag:
Public Library of Science (PLoS)
Publikationsdatum:
2023
ZDB Id:
2267670-3
