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- Title
Clinical and histopathological features related to time to complete remission in adult-onset minimal change nephrotic syndrome patients with corticosteroid treatment.
- Authors
Morioka, Fumiyuki; Nakatani, Shinya; Nishide, Kozo; Machiba, Yuri; Uedono, Hideki; Tsuda, Akihiro; Ishimura, Eiji; Mori, Katsuhito; Emoto, Masanori
- Abstract
Background: Minimal change nephrotic syndrome (MCNS) is a common type of nephrotic syndrome in adults, though evidence regarding its clinical and histopathological features related to time to complete remission (CR) is limited. Methods: This was a retrospective study of biopsy-proven, first-onset, adult MCNS patients who achieved CR after undergoing corticosteroid treatment. Body weight (BW) change rate was calculated as follows: (BW at admission − BW at discharge)/BW at discharge × 100. Histopathological examinations were performed, with particular attention given to tubulointerstitial lesions. Results: Fifty-seven patients (median 41 years old, range 22–63 years; 37 males) were diagnosed with MCNS from 2007 to 2020. Time to CR was a median 11 (8–21) days. In addition to serum creatinine and urinary protein, BW change rate also showed a positive correlation with time to CR (rs = 0.438, p < 0.001; rs = 0.280, p = 0.035; rs = 0.544, p < 0.001; respectively), while multivariate Cox proportional hazards models also revealed those factors as significant predictors for longer time to CR. In MCNS patients with a higher BW change rate (n = 28), serum creatinine, urinary protein, histopathological score, and time to CR were significantly greater as compared to those with a lower BW change rate (n =29). Also, in those patients, histopathological interstitial edema was significantly associated with longer time to CR after adjustments for serum creatinine and urinary protein. Conclusion: The present results indicate that BW change rate can predict time to CR in adult-onset MCNS patients. Histopathologically, interstitial edema is also an important factor for time to CR in MCNS patients with greater BW increase.
- Subjects
NEPHROTIC syndrome; PROPORTIONAL hazards models; HISTOPATHOLOGY
- Publication
Clinical & Experimental Nephrology, 2022, Vol 26, Issue 10, p955
- ISSN
1342-1751
- Publication type
Article
- DOI
10.1007/s10157-022-02235-8