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Collapsing glomerulopathy: clinical characteristics and follow-up
1Department of Nephrology, Clinical Center, Skopje, Republic of Macedonia.
Summary
Idiopathic collapsing glomerulopathy, a distinct kidney disease, presents similarly to focal segmental glomerulosclerosis but has a worse prognosis. Patients with collapsing glomerulopathy show no renal survival after five years, unlike those with focal segmental glomerulosclerosis.
Area of Science:
- Nephrology
- Pathology
- Clinical Medicine
Background:
- Collapsing glomerulopathy shares histopathologic features with human immunodeficiency virus (HIV) nephropathy.
- Previous reports described nephrotic syndrome, progressive chronic renal failure, and glomerular capillary collapse.
Purpose of the Study:
- To evaluate the clinical characteristics and prognosis of idiopathic collapsing glomerulopathy.
- To compare collapsing glomerulopathy with noncollapsing focal segmental glomerulosclerosis (FSGS).
Main Methods:
- Retrospective analysis of 893 renal biopsies.
- Identification of 16 cases with collapsing glomerulopathy without HIV or drug abuse.
- Comparison with 29 patients with FSGS.
- Kaplan-Meier survival analysis over a 5-year follow-up period.
Main Results:
- Collapsing glomerulopathy patients had higher serum creatinine (183 micromol/L vs. 115 micromol/L) but not significantly different.
- Proteinuria and blood pressure levels were similar between groups.
- Survival was significantly worse for collapsing glomerulopathy patients (P=0.025).
- No renal function survival at 5 years for collapsing glomerulopathy patients versus 40% for FSGS patients.
Conclusions:
- Idiopathic collapsing glomerulopathy is a distinct clinicopathologic entity.
- It shares clinical features with FSGS but has a more rapid progression.
- Collapsing glomerulopathy carries a worse prognosis, rapidly leading to end-stage renal disease.