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Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective

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Resumo:Background: There is no study available from Pakistan on the longitudinal course of membranous nephropathy (MN). We aimed to analyse the clinicopathological profile, course, response to treatment and outcome of the disease in our setup. Methods: All consecutive adult patients (≥18 years) with MN on renal biopsy and on regular follow-up were included. Relevant data items were retrieved from case files and biopsy reports. The outcome variables included doubling of baseline serum creatinine or the development of end-stage renal disease (ESRD). Results: Of a total of 102 patients, 82 (80.4%) were males; mean age was 28.9±11.4 years. Peripheral oedema was present in 86 (84.3%), nephrotic-range proteinuria in 80 (78.4%), microscopic haematuria in 25 (24.5%), hypertension in 42 (41.2%), and renal dysfunction in 13 (12.7%) patients at the time of presentation. The mean follow-up period was 3±2 years. Overall, 22 (21.5%) subjects went into remission and a similar number experienced doubling of serum creatinine. Both conservative and immunosuppressive treatment groups had similar duration of follow-up. The proportion of patients with remission and doubling of serum creatinine was similar between the two groups (p=0.70 and p=0.91 respectively), while the proportion of patients progressing to ESRD was significantly higher in the group treated conservatively (p=0.03). Baseline proteinuria and serum creatinine were predictive of remission (p=0.04 and p=0.05 respectively). Conclusions: In conclusion, untreated MN has a higher risk of progression to ESRD. Baseline proteinuria and serum creatinine predict response to treatment. Randomised controlled trials are needed to confirm the effects of immunosuppressive treatment
Autores principais:Hyder Rizvi,Syed Abbas
Outros Autores:Naqvi,Rubina; Ahmed,Ejaz; Akhter,Fazal; Abbas,Khawar; Mubarak,Muhammed
Assunto:Adults end-stage renal disease membranous nephropathy nephrotic syndrome proteinuria
Ano:2016
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Hyder Rizvi,Syed Abbas
author2 Naqvi,Rubina
Ahmed,Ejaz
Akhter,Fazal
Abbas,Khawar
Mubarak,Muhammed
author2_role author
author
author
author
author
author_facet Hyder Rizvi,Syed Abbas
Naqvi,Rubina
Ahmed,Ejaz
Akhter,Fazal
Abbas,Khawar
Mubarak,Muhammed
author_role author
country_str PT
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datacite.creators.creator.creatorName.fl_str_mv Hyder Rizvi,Syed Abbas
Naqvi,Rubina
Ahmed,Ejaz
Akhter,Fazal
Abbas,Khawar
Mubarak,Muhammed
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Adults
end-stage renal disease
membranous nephropathy
nephrotic syndrome
proteinuria
datacite.titles.title.fl_str_mv Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
dc.creator.none.fl_str_mv Hyder Rizvi,Syed Abbas
Naqvi,Rubina
Ahmed,Ejaz
Akhter,Fazal
Abbas,Khawar
Mubarak,Muhammed
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692016000200006
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Portuguese Journal of Nephrology & Hypertension v.30 n.2 2016
dc.subject.none.fl_str_mv Adults
end-stage renal disease
membranous nephropathy
nephrotic syndrome
proteinuria
dc.title.fl_str_mv Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Background: There is no study available from Pakistan on the longitudinal course of membranous nephropathy (MN). We aimed to analyse the clinicopathological profile, course, response to treatment and outcome of the disease in our setup. Methods: All consecutive adult patients (≥18 years) with MN on renal biopsy and on regular follow-up were included. Relevant data items were retrieved from case files and biopsy reports. The outcome variables included doubling of baseline serum creatinine or the development of end-stage renal disease (ESRD). Results: Of a total of 102 patients, 82 (80.4%) were males; mean age was 28.9±11.4 years. Peripheral oedema was present in 86 (84.3%), nephrotic-range proteinuria in 80 (78.4%), microscopic haematuria in 25 (24.5%), hypertension in 42 (41.2%), and renal dysfunction in 13 (12.7%) patients at the time of presentation. The mean follow-up period was 3±2 years. Overall, 22 (21.5%) subjects went into remission and a similar number experienced doubling of serum creatinine. Both conservative and immunosuppressive treatment groups had similar duration of follow-up. The proportion of patients with remission and doubling of serum creatinine was similar between the two groups (p=0.70 and p=0.91 respectively), while the proportion of patients progressing to ESRD was significantly higher in the group treated conservatively (p=0.03). Baseline proteinuria and serum creatinine were predictive of remission (p=0.04 and p=0.05 respectively). Conclusions: In conclusion, untreated MN has a higher risk of progression to ESRD. Baseline proteinuria and serum creatinine predict response to treatment. Randomised controlled trials are needed to confirm the effects of immunosuppressive treatment
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person_str_mv Hyder Rizvi,Syed Abbas
Naqvi,Rubina
Ahmed,Ejaz
Akhter,Fazal
Abbas,Khawar
Mubarak,Muhammed
publishDate 2016
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
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spelling Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspectiveHyder Rizvi,Syed AbbasNaqvi,RubinaAhmed,EjazAkhter,FazalAbbas,KhawarMubarak,MuhammedAdultsend-stage renal diseasemembranous nephropathynephrotic syndromeproteinuriaopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692016000200006URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692016000200006URLHasVersion2016-06-01Background: There is no study available from Pakistan on the longitudinal course of membranous nephropathy (MN). We aimed to analyse the clinicopathological profile, course, response to treatment and outcome of the disease in our setup. Methods: All consecutive adult patients (≥18 years) with MN on renal biopsy and on regular follow-up were included. Relevant data items were retrieved from case files and biopsy reports. The outcome variables included doubling of baseline serum creatinine or the development of end-stage renal disease (ESRD). Results: Of a total of 102 patients, 82 (80.4%) were males; mean age was 28.9±11.4 years. Peripheral oedema was present in 86 (84.3%), nephrotic-range proteinuria in 80 (78.4%), microscopic haematuria in 25 (24.5%), hypertension in 42 (41.2%), and renal dysfunction in 13 (12.7%) patients at the time of presentation. The mean follow-up period was 3±2 years. Overall, 22 (21.5%) subjects went into remission and a similar number experienced doubling of serum creatinine. Both conservative and immunosuppressive treatment groups had similar duration of follow-up. The proportion of patients with remission and doubling of serum creatinine was similar between the two groups (p=0.70 and p=0.91 respectively), while the proportion of patients progressing to ESRD was significantly higher in the group treated conservatively (p=0.03). Baseline proteinuria and serum creatinine were predictive of remission (p=0.04 and p=0.05 respectively). Conclusions: In conclusion, untreated MN has a higher risk of progression to ESRD. Baseline proteinuria and serum creatinine predict response to treatment. Randomised controlled trials are needed to confirm the effects of immunosuppressive treatmentSociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology & Hypertension v.30 n.2 2016text/htmlengjournal articlehttp://purl.org/coar/resource_type/c_6501literature
spellingShingle Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
Hyder Rizvi,Syed Abbas
Adults
end-stage renal disease
membranous nephropathy
nephrotic syndrome
proteinuria
status SINGLETON
subject.fl_str_mv Adults
end-stage renal disease
membranous nephropathy
nephrotic syndrome
proteinuria
title Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
title_full Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
title_fullStr Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
title_full_unstemmed Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
title_short Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
title_sort Clinicopathological profile and prognosis of idiopathic membranous nephropathy in adults: a developing country perspective
topic Adults
end-stage renal disease
membranous nephropathy
nephrotic syndrome
proteinuria
topic_facet Adults
end-stage renal disease
membranous nephropathy
nephrotic syndrome
proteinuria
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692016000200006
visible 1