scholarly journals The Association between Glomerular Diameter and Secondary Focal Segmental Glomerulosclerosis in Chronic Kidney Disease

2021 ◽  
pp. 1-8
Author(s):  
Ryo Zamami ◽  
Kentaro Kohagura ◽  
Kojiro Kinjyo ◽  
Takuto Nakamura ◽  
Takanori Kinjo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Glomerular Hypertrophy ◽  
Glomerular Lesion ◽  
Segmental Glomerulosclerosis ◽  
Glomerular Size

<b><i>Introduction:</i></b> When nephron loss occurs, the glomerular filtration rate (GFR) is suggested to be maintained by glomerular hypertrophy, but excessive hypertrophy can rather lead to the formation of focal segmental glomerulosclerosis (FSGS), thereby causing progressive kidney damage. However, it is not clear how much glomerular hypertrophy leads to the formation of FSGS. We examined the association between glomerular diameter and FSGS lesions in chronic kidney disease (CKD) patients. <b><i>Methods:</i></b> We recruited 77 patients who underwent renal biopsy during 2016–2017; however, those identified with primary FSGS and glomerulonephritis with active glomerular lesion were excluded. We evaluated the maximal glomerular diameter (Max GD), an indicator of glomerular size, in each renal biopsy specimen and examined its association with FSGS lesion. <b><i>Results:</i></b> The median age, blood pressure, and estimated GFR of the patients were 53 years, 122/70 mm Hg, and 65 mL/min/1.73 m<sup>2</sup>, respectively. The optimal cutoff threshold of Max GD for predicting the presence of FSGS lesions, assessed by receiver operating characteristic curve analysis, was determined to be at 224 μm (area under the curve, 0.81; sensitivity, 81%; specificity, 72%). Multivariate logistic regression analyses demonstrated that Max GD ≥224 μm was significantly associated with the presence of FSGS lesions, independent of other confounding factors (odds ratio, 11.70; 95% confidence interval, 1.93–70.84). <b><i>Discussion/Conclusion:</i></b> Glomerular hypertrophy (Max GD ≥224 μm) has been associated with FSGS lesions in CKD patients and may reflect the limits of the compensatory process.

scholarly journals Chronic kidney disease: a review of proteomic and metabolomic approaches to membranous glomerulonephritis, focal segmental glomerulosclerosis, and IgA nephropathy biomarkers

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Amir Taherkhani ◽  
Reyhaneh Farrokhi Yekta ◽  
Maede Mohseni ◽  
Massoud Saidijam ◽  
Afsaneh Arefi Oskouie
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iga Nephropathy ◽  
Focal Segmental Glomerulosclerosis ◽  
Membranous Glomerulonephritis ◽  
Renal Diseases ◽  
Segmental Glomerulosclerosis ◽  
Therapeutic Procedures ◽  
Definition Of ◽  
End Stage

AbstractChronic Kidney Disease (CKD) is a global health problem annually affecting millions of people around the world. It is a comprehensive syndrome, and various factors may contribute to its occurrence. In this study, it was attempted to provide an accurate definition of chronic kidney disease; followed by focusing and discussing on molecular pathogenesis, novel diagnosis approaches based on biomarkers, recent effective antigens and new therapeutic procedures related to high-risk chronic kidney disease such as membranous glomerulonephritis, focal segmental glomerulosclerosis, and IgA nephropathy, which may lead to end-stage renal diseases. Additionally, a considerable number of metabolites and proteins that have previously been discovered and recommended as potential biomarkers of various CKDs using ‘-omics-’ technologies, proteomics, and metabolomics were reviewed.

scholarly journals Utility of Genomic Testing after Renal Biopsy

2019 ◽  
Vol 51 (1) ◽  
pp. 43-53
Author(s):  
Susan L. Murray ◽  
Anthony Dorman ◽  
Katherine A. Benson ◽  
Dervla M. Connaughton ◽  
Caragh P. Stapleton ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Kidney Disease ◽  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Alport Syndrome ◽  
Kidney Biopsy ◽  
Genetic Diagnosis ◽  
Pathological Diagnosis ◽  
Genetic Sequencing ◽  
Segmental Glomerulosclerosis

Background: Renal biopsy is the mainstay of renal pathological diagnosis. Despite sophisticated diagnostic techniques, it is not always possible to make a precise pathological diagnosis. Our aim was to identify a genetic cause of disease in patients who had undergone renal biopsy and determine if genetic testing altered diagnosis or treatment. Methods: Patients with suspected familial kidney disease underwent a variety of next-generation sequencing (NGS) strategies. The subset of these patients who had also undergone native kidney biopsy was identified. Histological specimens were reviewed by a consultant pathologist, and genetic and pathological diagnoses were compared. Results: Seventy-five patients in 47 families underwent genetic sequencing and renal biopsy. Patients were grouped into 5 diagnostic categories based on pathological diagnosis: tubulointerstitial kidney disease (TIKD; n = 18); glomerulonephritis (GN; n = 15); focal segmental glomerulosclerosis and Alport Syndrome (n = 11); thrombotic microangiopathy (TMA; n = 17); and nonspecific pathological changes (n = 14). Thirty-nine patients (52%) in 21 families (45%) received a genetic diagnosis; 13 cases (72%) with TIKD, 4 (27%) with GN, 6 (55%) with focal segmental glomerulosclerosis/Alport syndrome, and 10 (59%) with TMA and 6 cases (43%) with nonspecific features. Genetic testing resulted in changes in understanding of disease mechanism in 21 individuals (54%) in 12 families (57%). Treatment would have been altered in at least 26% of cases (10/39). Conclusions: An accurate genetic diagnosis can result in changes in clinical diagnosis, understanding of pathological mechanism, and treatment. NGS should be considered as a complementary diagnostic technique to kidney biopsy in the evaluation of patients with kidney disease.

scholarly journals Spectrum of Renal Parenchymal Diseases: An Eleven Year Retrospective Review of Renal Biopsy Data from a Tertiary Care Hospital in Pakistan

2017 ◽  
Vol 23 (1) ◽  
Author(s):  
Naila Asif ◽  
Muhammad Nadeem Ahsan ◽  
Shafqat Waqar Khanzada
Keyword(s):  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Membranous Nephropathy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Glomerular Disease ◽  
Care Hospital ◽  
Glomerular Lesion ◽  
Segmental Glomerulosclerosis ◽  
Renal Biopsies

<p><strong>Objective:</strong><strong>  </strong>To report our experience with renal biopsy and histopathological pattern of renal disease in a tertiary care hospital in Pakistan over 11 years period.</p><p><strong>Methods:</strong><strong>  </strong>All the kidney biopsies performed in our unit from Jan 2001 to Dec 2011 were retrospectively reviewed. We recorded the following data for each patient: name, age, sex, indications for renal biopsy, histopathological diagnosis and lab investigations such as Serum Creatinine, 24 hour urinary protein, urine microscopy, virology (Hbs Ag, Anti HCV) and serology (antids DNA, ANA, C3, C4, C-ANCA and p-ANCA) when indicated. Histopathological examination included Light Microscopy (LM) and Immunofluorescence Microscopy (IF). For LM, six sections were taken and stained with Haemotoxilin and Eosin, and special stains included Periodic acid-Schiff (PAS), Trichome and Grocott’ Smethanamine Silver Stain (GMS). IF study was done using polyclonal antisera against human IgG, IgM, IgA, C3 and Cq. The renal biopsies were performed by a trained Nephrologist.</p><p><strong>Results:</strong><strong>  </strong>A total of 329 consecutive percutaneous renal biopsies of native kidneys were reviewed. A total of thirteen specimens were unsatisfactory. Nineteen cases had incomplete data, therefore were excluded. There were 159 males (53.3%) and 138 females (46.46%). Age distribution showed a total no. of 34 (11.44%) of paediatric cases, 238 (80.13%) adult cases and 25 (10.5 %) elderly cases. The most common clinical indication for renal biopsy was unexplained renal failure (n = 116 39%) followed by nephrotic syndrome (n = 83 27.9%). Of the total biopsies included 248 (82.82%) had glomerular disease and 49 (16.49%) had non glomerular disease. The most frequently found primary glomerular lesion was membranous nephropathy (n = 51 17%) followed by focal segmental glomerulosclerosis (n = 26 8.7%). Amongst the non-glomerular lesions, CIN (chronic interstitial nephritis) was the most frequently found lesion (n = 24 8.08%).</p><p><strong>Conclusion:  </strong>Membranous Nephropathy followed by Focal Segmental Glomerulosclerosis were the most frequently found renal lesion.</p>

scholarly journals Relevance of Endothelial Cell-Specific Molecule 1 (Endocan) Plasma Levels for Predicting Pulmonary Infection after Cardiac Surgery in Chronic Kidney Disease Patients: The Endolung Pilot Study

2017 ◽  
Vol 8 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Andréa Perrotti ◽  
Camille Chenevier-Gobeaux ◽  
Fiona Ecarnot ◽  
Benoit Barrucand ◽  
Philippe Lassalle ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiac Surgery ◽  
Pilot Study ◽  
Kidney Disease ◽  
Plasma Levels ◽  
Operating Characteristic ◽  
Pulmonary Infection ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Reactive Protein

Objectives: This pilot study aimed to evaluate the relevance of endocan plasma levels for predicting pulmonary infection after cardiac surgery in patients with chronic kidney disease (CKD). Methods: Serum collected in a previous prospective cohort study (from 166 patients with preoperative CKD who underwent cardiac surgery) was used. Five patients with postoperative pulmonary infection were compared with 15 randomly selected CKD patients with an uneventful outcome. Blood samples were tested at 4 time points (preoperatively and 6, 12, and 24 h after the end of surgery). Endocan, procalcitonin, and C-reactive protein plasma levels were compared between the two groups. Results: At 6 h, the patients with pulmonary infection had significantly higher levels of endocan than the patients without pulmonary infection (24.2 ± 15.6 vs. 6.4 ± 3.2 ng/mL; p = 0.03). A receiver operating characteristic curve analysis showed 80% sensitivity and 100% specificity for endocan to predict pulmonary infection (area under the curve 0.84), with a cutoff value of 15.9 ng/mL. The time saved by assessment of the endocan dosage compared to a clinical diagnosis of pulmonary infection was 47 h. Conclusion: This pilot study showed that a specific study to assess the link between endocan plasma levels and pulmonary infection after cardiac surgery in CKD patients is of potential utility.

scholarly journals Upper Normal Serum Creatinine Concentrations as a Predictor for Chronic Kidney Disease: Analysis of 14 Years’ Korean Genome and Epidemiology Study (KoGES)

2018 ◽  
Vol 7 (11) ◽  
pp. 463 ◽  
Author(s):  
Jong Jhee ◽  
Seun Hwang ◽  
Joon Song ◽  
Seoung Lee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Normal Serum ◽  
Epidemiology Study ◽  
Normal Range ◽  
Increased Risk ◽  
Cox Analysis

Both serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) have been used to assess kidney function in public health check-ups. However, when the sCr is within the normal levels but the eGFR is <60 mL/min/1.73 m2, a dilemma arises, as the patients might progress to chronic kidney disease (CKD) after several years. We aimed to evaluate the association between normal sCr and the risk of incident CKD in the general population. For this, 9445 subjects from the Korean Genome and Epidemiology Study, with normal sCr and eGFR of >60 mL/min/1.73 m2 were analyzed. The subjects were classified into quartiles based on sCr levels. The primary outcome was the development of eGFR <60 mL/min/1.73 m2 on two consecutive measures. During a mean follow-up of 8.4 ± 4.3 years, 779 (8.2%) subjects developed eGFR <60 mL/min/1.73 m2. The incidence of the development of eGFR <60 mL/min/1.73 m2 was higher in the higher quartiles than in the lowest quartile. In multivariable Cox analysis, the highest quartile was associated with an increased risk for the development of eGFR <60 mL/min/1.73 m2 (hazard ratio (HR), 4.71; 95% confidence interval (CI), 3.29–6.74 in females; HR, 12.77; 95% CI, 7.69–21.23 in males). In the receiver operating characteristic curve analysis, adding sCr to the traditional risk factors for CKD improved the accuracy of predicting the development of eGFR <60 mL/min/1.73 m2 (area under the curve, 0.83 vs. 0.80 in females and 0.85 vs. 0.78 in males), and the cutoff value of sCr was 0.75 mg/dL and 0.78 mg/dL in females and males. Cautious interpretation is necessary when sCr is within the normal range, considering that the upper normal range of sCr has a higher risk of CKD development.

Predictive factors of chronic kidney disease in primary focal segmental glomerulosclerosis

2006 ◽  
Vol 21 (7) ◽  
pp. 1003-1012 ◽  
Author(s):  
Marcelo M. Abrantes ◽  
Luis Sergio B. Cardoso ◽  
Eleonora M. Lima ◽  
José M. Penido Silva ◽  
José S. Diniz ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Focal Segmental Glomerulosclerosis ◽  
Predictive Factors ◽  
Segmental Glomerulosclerosis
Sign in / Sign up

Export Citation Format

Share Document