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10.1159/000449511

http://scihub22266oqcxt.onion/10.1159/000449511
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C5069171!5069171!27626625
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suck abstract from ncbi


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pmid27626625      Am+J+Nephrol 2016 ; 44 (4): 289-99
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  • Renal interstitial fibrosis: an imperfect predictor of kidney disease progression in some patient cohorts #MMPMID27626625
  • Menn-Josephy H; Lee CS; Nolin A; Christov M; Rybin DV; Weinberg JM; Henderson J; Bonegio R; Havasi A
  • Am J Nephrol 2016[]; 44 (4): 289-99 PMID27626625show ga
  • Background: The extent of interstitial fibrosis on kidney biopsy is regarded as a prognostic indicator and guide to treatment. Patients with extensive fibrosis are assigned to supportive treatments with the expectation that they have advanced beyond the point at which immunosuppressive or other disease modifying therapies would be of benefit. Our study highlights some of the limitations of using interstitial fibrosis to predict who will develop ESRD. Methods: Analysis of 434 consecutive renal biopsies performed between 2001-2012 at a single center. We assessed the influence of various clinical factors along with fibrosis as predictors of ESRD and dialysis free survival in various patient groups. Results: Interstitial fibrosis performed well overall as a predictor of progression to dialysis and on average patients with >50% fibrosis progressed more rapidly than those with either 25-49% or 0-24% fibrosis with a median time to dialysis of 1.2 years, 6.5 and >10 years respectively. In contrast, interstitial fibrosis was of less value as a predictor of disease progression in a subset of cases that included patients over the age of 70 and those with diabetic nephropathy on biopsy. Surprisingly, 13.9% of patients with normal renal function had 25-49% fibrosis and 5% had more than 50% fibrosis on biopsy and 5 years after undergoing biopsy 21% of patients with >50% fibrosis still remained dialysis free. Conclusion: Renal fibrosis is an imperfect prognostic indicator for the development of ESRD and caution should be exercised in applying it too rigidly, especially in elderly or diabetic patients.
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