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2016 ; 95
(21
): e3786
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Patients With Combined Membranous Nephropathy and Focal Segmental
Glomerulosclerosis Have Comparable Clinical and Autoantibody Profiles With
Primary Membranous Nephropathy: A Retrospective Observational Study
#MMPMID27227951
Gu QH
; Cui Z
; Huang J
; Zhang YM
; Qu Z
; Wang F
; Wang X
; Wang SX
; Liu G
; Zhao MH
Medicine (Baltimore)
2016[May]; 95
(21
): e3786
PMID27227951
show ga
Patients with combined membranous nephropathy (MN) and focal segmental
glomerulosclerosis (FSGS) have been reported with different clinical
significance. Investigations on the possible mechanisms of the combined
glomerular lesions are necessary but scarce. Twenty patients with both MN and
FSGS lesions were enrolled in the study. Sixty-five patients with primary MN and
56 patients with primary FSGS were used as disease controls. Clinical data on
renal biopsy and during follow-up were collected. Circulating anti-phospholipase
A2 receptor (PLA2R) antibody, glomerular PLA2R expression, IgG4 deposition, and
soluble urokinase receptor (suPAR) levels were detected. We found that patients
with combined lesions presented with older age, less proteinuria, higher albumin,
and better renal function on biopsy. These were comparable to the patients with
primary MN, but differed from the patients with primary FSGS. Patients with
combined lesions showed higher stages of MN, no cellular variant on FSGS
classification, and more common (100.0%) tubulointerstitial injury than both
primary MN and primary FSGS patients. In the patients with combined lesions,
80.0% had circulating anti-PLA2R antibody and 68.4% had IgG4 predominant
deposition in glomeruli, which were comparable to primary MN. The patients with
combined lesions had significantly lower urinary suPAR concentrations, than the
primary FSGS patients (315.6?±?151.0 vs 752.1?±?633.9?pg/?mol; P?=?0.002), but
similar to the primary MN patients (267.9?±?147.5?pg/?mol). We conclude that
patients with combined MN and FSGS may share the same underlying pathogenesis
with primary MN. The FSGS lesion might be secondary to primary MN.