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Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa

BACKGROUND AND AIM: Mesangiocapillary glomerulonephritis (MCGN) is a common cause of chronic kidney disease in developing countries. Data on the renal outcome of patients with idiopathic MCGN is limited. The aim of this study is to investigate the outcome of patients with idiopathic MCGN presenting...

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Autores principales: Okpechi, Ikechi G., Dlamini, Thandiwe A. L., Duffield, Maureen, Rayner, Brian L., Moturi, George, Swanepoel, Charles R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239048/
https://www.ncbi.nlm.nih.gov/pubmed/25411791
http://dx.doi.org/10.1371/journal.pone.0113302
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author Okpechi, Ikechi G.
Dlamini, Thandiwe A. L.
Duffield, Maureen
Rayner, Brian L.
Moturi, George
Swanepoel, Charles R.
author_facet Okpechi, Ikechi G.
Dlamini, Thandiwe A. L.
Duffield, Maureen
Rayner, Brian L.
Moturi, George
Swanepoel, Charles R.
author_sort Okpechi, Ikechi G.
collection PubMed
description BACKGROUND AND AIM: Mesangiocapillary glomerulonephritis (MCGN) is a common cause of chronic kidney disease in developing countries. Data on the renal outcome of patients with idiopathic MCGN is limited. The aim of this study is to investigate the outcome of patients with idiopathic MCGN presenting to the Groote Schuur Hospital (GSH) Renal Unit in Cape Town. MATERIALS AND METHODS: A retrospective study of patients with idiopathic MCGN followed up at our clinic. Seventy-nine patients with no identifiable cause of MCGN were included for analysis. A composite renal outcome of persistent doubling of serum creatinine or end stage renal disease (ESRD) was used. Kaplan Meier survival and Cox regression analysis were used to assess survival and identify factors predicting the outcome. RESULTS: The mean age at biopsy was 33.9±13.6 years and 41.8% were black. Mean duration of follow up was 13.5±18.8 months. Twenty-three patients (34.2%) reached the composite endpoint. Overall, median renal survival was 38.7±11.7 months (95% CI 15.7–61.8) with 2-year and 5-year renal survival of 61% and 40.3% respectively. No significant difference was found for renal survival between males and females, treatment or non-treatment with immunosuppression, presence or absence of crescents or histological type of MCGN (p>0.05). On univariate Cox-regression analysis, factors found to be associated with the outcome were the estimated glomerular filtration rate at biopsy (OR 0.97 [95%CI: 0.95–0.99], p<0.0001), black race (OR 3.03 [95%CI: 1.27–7.21], p = 0.012) and presence of interstitial fibrosis in the biopsy (OR 2.64 [95%CI: 1.07–6.48], p = 0.034). Age, systolic blood pressure and attaining complete or partial remission approached significant values with the endpoint. CONCLUSIONS: The outcome of idiopathic MCGN in Cape Town is poor and requires further prospective studies to improve our understanding of this common disease.
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spelling pubmed-42390482014-11-26 Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa Okpechi, Ikechi G. Dlamini, Thandiwe A. L. Duffield, Maureen Rayner, Brian L. Moturi, George Swanepoel, Charles R. PLoS One Research Article BACKGROUND AND AIM: Mesangiocapillary glomerulonephritis (MCGN) is a common cause of chronic kidney disease in developing countries. Data on the renal outcome of patients with idiopathic MCGN is limited. The aim of this study is to investigate the outcome of patients with idiopathic MCGN presenting to the Groote Schuur Hospital (GSH) Renal Unit in Cape Town. MATERIALS AND METHODS: A retrospective study of patients with idiopathic MCGN followed up at our clinic. Seventy-nine patients with no identifiable cause of MCGN were included for analysis. A composite renal outcome of persistent doubling of serum creatinine or end stage renal disease (ESRD) was used. Kaplan Meier survival and Cox regression analysis were used to assess survival and identify factors predicting the outcome. RESULTS: The mean age at biopsy was 33.9±13.6 years and 41.8% were black. Mean duration of follow up was 13.5±18.8 months. Twenty-three patients (34.2%) reached the composite endpoint. Overall, median renal survival was 38.7±11.7 months (95% CI 15.7–61.8) with 2-year and 5-year renal survival of 61% and 40.3% respectively. No significant difference was found for renal survival between males and females, treatment or non-treatment with immunosuppression, presence or absence of crescents or histological type of MCGN (p>0.05). On univariate Cox-regression analysis, factors found to be associated with the outcome were the estimated glomerular filtration rate at biopsy (OR 0.97 [95%CI: 0.95–0.99], p<0.0001), black race (OR 3.03 [95%CI: 1.27–7.21], p = 0.012) and presence of interstitial fibrosis in the biopsy (OR 2.64 [95%CI: 1.07–6.48], p = 0.034). Age, systolic blood pressure and attaining complete or partial remission approached significant values with the endpoint. CONCLUSIONS: The outcome of idiopathic MCGN in Cape Town is poor and requires further prospective studies to improve our understanding of this common disease. Public Library of Science 2014-11-20 /pmc/articles/PMC4239048/ /pubmed/25411791 http://dx.doi.org/10.1371/journal.pone.0113302 Text en © 2014 Okpechi et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Okpechi, Ikechi G.
Dlamini, Thandiwe A. L.
Duffield, Maureen
Rayner, Brian L.
Moturi, George
Swanepoel, Charles R.
Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa
title Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa
title_full Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa
title_fullStr Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa
title_full_unstemmed Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa
title_short Outcome of Patients with Primary Immune-Complex Type Mesangiocapillary Glomerulonephritis (MCGN) in Cape Town South Africa
title_sort outcome of patients with primary immune-complex type mesangiocapillary glomerulonephritis (mcgn) in cape town south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239048/
https://www.ncbi.nlm.nih.gov/pubmed/25411791
http://dx.doi.org/10.1371/journal.pone.0113302
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