Clinical outcomes and predictors for ESRD and mortality in primary GN

Yu Hsiang Chou, Yu Chung Lien, Fu Chang Hu, Wei Chou Lin, Chih Chin Kao, Chun Fu Lai, Wen Chih Chiang, Shuei Liong Lin, Tun Jun Tsai, Kwan Dun Wu, Yung Ming Chen

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Abstract

Background and objectives Relatively little is known about the long-termoutcomes of different histologic types of primary glomerulonephritis in Asian populations. Design, setting, participants, & measurements From 1993 to 2006, 987 patients undergoing renal biopsy were studied, and 580 patients (mean age=44.4 years, male=58.5%) with the four most common forms of glomerulonephritis (membranous nephropathy, focal and segmental glomerulosclerosis, IgA nephropathy, and minimal change disease) were selected for analysis. Median follow-up period was 5.9 (interquartile range=5.7) years. Results The focal and segmental glomerulosclerosis group displayed the highest incidence of ESRD (25.8%) and the fastest decline of estimated GFR (4.6 ml/min per 1.73 m2 per year). The IgA nephropathy group also had a higher rate of ESRD than the membranous nephropathy patients (19.2% versus 4.3%, P<0.001). In contrast, the membranous nephropathy group exhibited an overall death rate similar to the focal and segmental glomerulosclerosis group (17.2% versus 14.4%) but higher than the IgA nephropathy and minimal change disease patients (4.6% and 3.7%, respectively, P<0.001). The most powerful predictor for ESRD was focal and segmental glomerulosclerosis, whereas the strongest predictor for all-cause mortality was membranous nephropathy with higher proteinuria. Protectors against ESRD included male sex and higher hemoglobin. Conclusions Most predictors for ESRD and overall mortality found in this ethnic Chinese cohort were similar to other studies. However, some risk factors linked with distinct glomerular pathologies displayed differential clinical outcomes.

Original languageEnglish
Pages (from-to)1401-1408
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume7
Issue number9
DOIs
Publication statusPublished - Sep 1 2012
Externally publishedYes

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ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Chou, Y. H., Lien, Y. C., Hu, F. C., Lin, W. C., Kao, C. C., Lai, C. F., Chiang, W. C., Lin, S. L., Tsai, T. J., Wu, K. D., & Chen, Y. M. (2012). Clinical outcomes and predictors for ESRD and mortality in primary GN. Clinical Journal of the American Society of Nephrology, 7(9), 1401-1408. https://doi.org/10.2215/CJN.04500511