Long-term Outcome of Biopsy-Proven Minimal Change Nephropathy in Chinese Adults
Publication in refereed journal


摘要Background: Minimal change nephropathy is a common cause of primary nephrotic syndrome in adults. However, there are few studies of its clinical course, response to treatment, and long-term outcome.
Study Design: Retrospective cohort study.
Setting & Participants: 340 consecutive adult patients with nephrotic syndrome and biopsy-proven minimal change nephropathy treated in a university hospital from 1984 until 2004.
Factors: Treatment response groups: primary steroid resistance, frequent relapse (≥4 relapses within 1 year), infrequent relapse (≥1 relapse but not frequent relapse), and no relapse (reference group); disease pattern.
Outcome: Medical problems after diagnosis; patient survival; renal survival.
Results: Median time to remission was 10 (IQR, 8-12) weeks; 179 (52.6%) had no relapse, 42 (12.4%) had infrequent relapses, 86 (25.3%) were frequent relapsers or steroid dependent, and 33 (9.7%) had primary steroid resistance. After a median follow-up of 174.7 (IQR, 119.7-235.0) months, 32 patients developed end-stage renal disease and 62 died (25 after progression to end-stage renal disease). Cox regression analysis showed that age and treatment response groups were the independent predictors of patient survival. Compared to the no-relapse group, the infrequent-relapse group had significantly better patient survival (adjusted HR, 0.19; 95% CI, 0.08-0.44; P < 0.001), whereas the primary-steroid-resistance group had significantly worse patient survival (adjusted HR, 5.87; 95% CI, 1.83-18.85; P < 0.001). Renal survival was excellent except in the primary-steroid-resistance group.
Limitations: Retrospective study.
Conclusions: A substantial proportion of adult patients with minimal change nephropathy continue to have disease flares more than 10 years after the initial presentation, and medical problems after diagnosis are common.
著者Cheuk-Chun Szeto, Fernand Mac-Moune Lai, Kai-Ming Chow, Bonnie Ching-Ha Kwan, Vickie Wai-Ki Kwong, Chi-Bon Leung, Philip Kam-Tao Li
期刊名稱American Journal of Kidney Diseases
出版社W. B. Saunders Co., Ltd.
出版地United Kingdom
頁次710 - 718
關鍵詞adult onset, end-stage renal disease (ESRD), glucocorticoid, kidney biopsy, Minimal change nephropathy (MCN), nephrotic syndrome, relapse, disease flare, remission, glomerulonephritis, renal survival, steroid resistant

上次更新時間 2022-16-01 於 23:47