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[Type I and III membranoproliferative glomerulonephritis. Clinical picture and prognosis]
K Matousovic1, P Rossmann, V Prát
1Program výzkumu transplantací orgánů, Institutu klinické a experimentální medicíny, Praha.
Insights
Membranoproliferative glomerulonephritis (MPGN) types I and III affects 15.5% of primary cases, with elevated creatinine linked to hypertension and proteinuria. Long-term kidney function and cure rates remain low for these patients.
Area of Science:
- Nephrology
- Pathology
Context:
- Membranoproliferative glomerulonephritis (MPGN) comprises types I and III.
- This study analyzed 154 patients diagnosed with MPGN types I and III.
Purpose:
- To investigate the clinical characteristics and outcomes of MPGN types I and III.
- To identify factors associated with disease progression and kidney function.
Summary:
- The study found that 15.5% of primary glomerulonephritis cases were MPGN types I and III, predominantly affecting men (60%).
- Hypertension, significant proteinuria (mean 6.5 g/24h), and erythrocyturia were common findings at biopsy.
- Elevated serum creatinine was observed in half the patients and correlated with blood pressure, proteinuria, and histological findings like extracapillary proliferation and tubulointerstitial regression.
Impact:
- The findings highlight the significant association between clinical parameters and histological features in MPGN types I and III.
- Long-term follow-up revealed cumulative kidney function rates of 41% and 28% at 10 and 20 years, respectively.
- The cumulative cure rate was only 14% at 10 years post-biopsy, indicating a poor prognosis for these patients.
Abstract:
Membranoproliferative glomerulonephritis (CN) of types I and III was diagnosed in 154 patients (15.5% out of primary CN). Out of this number 60% were men. During biopsy, one third of the patients were normotensive, 40% were slightly hypertensive and one third suffered from severe hypertension. Mean proteinuria was 6.5 +/- 5.5 g/24 h. In two thirds of the patients erythrocyturia was higher than 35 mil. in Addis' sediment and the findings in the urine were characterised by the proportion between proteinuria and erythrocyturia (p less than 0.001). During biopsy in one half of the patients, the serum creatinine level was already elevated. The presence of creatininemia was found to be directly linked to blood pressure, proteinuria, the degrees of extracapillary proliferation, tubulointerstitial regression and vascular arteriolosclerosis. The cumulative duration of the kidney function within the period of 10-20 years was 41 or 28%, the cumulative cure amounted to 14% 10 years after biopsy.