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Collapsing glomerulopathy: a 30-year perspective and single, large center experience.
L Nicholas Cossey1, Christopher P Larsen1, Helen Liapis1,2
1Renal Pathology Division, Arkana Laboratories, Little Rock, AR, USA.
Collapsing glomerulopathy (CGP) is a kidney disease pattern often seen in those with African ancestry. Recent advances link CGP to genetic factors like APOL1 variants, shifting diagnosis towards molecular insights.
Area of Science:
- Nephrology
- Pathology
- Genetics
Background:
- Collapsing glomerulopathy (CGP) is a severe kidney injury pattern.
- It disproportionately affects individuals of African ancestry.
- CGP presents as rapidly progressive renal failure and nephrotic-range proteinuria.
Purpose of the Study:
- To review the evolution of collapsing glomerulopathy.
- To discuss its history, pathomechanisms, and disease spectrum.
- To emphasize the shift towards molecular diagnostics in CGP.
Main Methods:
- Review of historical data and clinical experience.
- Analysis of pathological findings in renal biopsies.
- Integration of genetic associations, including APOL1-risk variants.
Main Results:
- CGP has evolved from an HIV-associated diagnosis to one with diverse etiologies.
- Apolipoprotein L1 (APOL1)-risk variants are frequently implicated.
- Distinguishing CGP from mimics and linking histology to cause are crucial.
Conclusions:
- CGP diagnosis is increasingly incorporating molecular data beyond morphology.
- A comprehensive, molecular approach aids in risk stratification and personalized treatment.
- Further research into molecular pathways is needed for effective therapies.
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