Abstract:
Minimal Change Disease (MCD) and Focal Segmental Glomerulosclerosis (FSGS) are the main causes of nephrotic syndrome in the world. The complement system appears to play an important role in the pathogenesis of these diseases. To evaluate the deposition of immunoglobulins and particles of the complement system in renal biopsies of patients with FSGS and MCD and relate to laboratory data, we selected 59 renal biopsies from patients with podocytopathies, 31 from patients with FSGS and 28 with MCD. Epidemiological, clinical, laboratory information and the prognosis of these patients were evaluated. Analysis of the deposition of IgM, IgG, C3, C1q and C4d in renal biopsies was performed. We related IgM and C3 deposition with laboratory parameters. Statistical analysis was performed using GraphPad Prism version 7.0. Glomerular deposition of IgM was significantly higher in the FSGS group, as was codeposition of IgM and C3. The clinical course of patients and laboratory data were also worse in cases of FSGS, with a higher percentage progressing to chronic kidney disease and death. Patients with C3 deposition had significantly higher mean serum creatinine and significantly lower eGFR, regardless of disease. Patients with FSGS had more IgM and C3 deposition in renal biopsies, worse laboratory data and prognosis than patients with MCD. C3 deposition, both in FSGS and MCD, appears to be related to worsening renal function.
摘要:
微小病变疾病(MCD)和局灶节段肾小球硬化(FSGS)是肾病综合征的主要病因。补体系统似乎在这些疾病的发病机理中起重要作用。评估FSGS和MCD患者肾活检中免疫球蛋白和补体系统颗粒的沉积,并与实验室数据相关。我们从有足细胞病变的患者中选择了59个肾活检,FSGS患者31例,MCD患者28例。流行病学,临床,评估这些患者的实验室信息和预后.IgM的沉积分析,IgG,在肾活检中进行C3、C1q和C4d。我们将IgM和C3沉积与实验室参数相关联。使用GraphPadPrism版本7.0进行统计分析。肾小球沉积IgM在FSGS组明显增高,IgM和C3的共沉积也是如此。FSGS患者的临床病程和实验室数据也更差,进展为慢性肾病和死亡的比例更高。有C3沉积的患者有显著较高的平均血清肌酐和显著较低的eGFR,不管疾病。FSGS患者在肾活检中有更多的IgM和C3沉积,实验室数据和预后比MCD患者差。C3沉积,在FSGS和MCD中,似乎与肾功能恶化有关。