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Collapsing Glomerulopathy in Brazil: A Nationwide Descriptive Study

Marcos Adriano Garcia Campos1, Precil Diego Miranda de Meneses Neves2, Érico Murilo Monteiro Cutrim3

  • 1Duke Global Health Institute, Duke University, Durham, North Carolina, USA.

Nephrology (Carlton, Vic.)
|December 15, 2025
PubMed

Insights

Collapsing glomerulopathy (CG) rapidly leads to kidney failure, affecting young adults. This study highlights high rates of progression to renal replacement therapy (RRT) within three months, emphasizing the need for early intervention in CG patients.

Area of Science:

  • Nephrology
  • Glomerular Diseases
  • Renal Pathology

Background:

  • Collapsing glomerulopathy (CG) is a severe kidney disease with rapid progression to end-stage renal disease.
  • Brazil's high burden of infectious diseases and prevalence of APOL1 risk variants make it a key location for CG research.
  • Understanding CG's clinical and pathological features is crucial for improving patient outcomes.

Purpose of the Study:

  • To describe the clinical characteristics of collapsing glomerulopathy (CG) patients in Brazil.
  • To analyze histopathological findings associated with CG.
  • To determine the outcomes, including progression to renal replacement therapy (RRT), in a Brazilian CG cohort.

Main Methods:

  • A retrospective analysis of data from 330 patients diagnosed with CG via kidney biopsy (KB) between 2014 and 2022 across 18 Brazilian nephrology centers.
  • Data collection included initial symptoms, treatments, and evolution to RRT.
  • Immunofluorescence findings and secondary etiologies, including HIV, autoimmune diseases, and APOL1 high-risk genotypes, were assessed.

Main Results:

  • The study included 330 patients, predominantly young men of Brown/Black ethnicity (mean age 32 years).
  • Common symptoms included loss of renal function, nephrotic proteinuria, and hematuria. Kidney biopsies showed varying degrees of tubular atrophy, interstitial fibrosis, interstitial inflammation, and acute tubular necrosis.
  • Secondary causes like HIV, autoimmune diseases, and APOL1 high-risk genotypes were identified in a significant proportion. Thirty-five percent of patients progressed to RRT within three months.

Conclusions:

  • Collapsing glomerulopathy (CG) significantly impacts young individuals, with a substantial proportion requiring renal replacement therapy (RRT) within three months of diagnosis.
  • This multicenter study provides essential baseline data on risk factors and outcomes for CG in Brazil.
  • Further research is warranted to explore targeted interventions for this aggressive glomerular disease.
Abstract

Keywords:
chronic kidney diseasecollapsing glomerulopathyepidemiologykidney biopsyrenal replacement therapy

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