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Distribution of pathologic findings in individuals with nephrotic proteinuria according to serum albumin.
Nephrol Dial Transplant. 2008 May; 23(5):1595-9.ND

Abstract

BACKGROUND

Previous studies of the nephrotic syndrome have not carefully examined the relationship between serum albumin and the distribution of pathologic diagnoses found at the time of biopsy. The spectrum of pathologic findings in individuals with nephrotic proteinuria and a normal serum albumin has not been determined. Knowledge regarding the spectrum of findings in nephrotic proteinuria according to serum albumin levels may help nephrologists in the clinical decision making of when to perform a renal biopsy and in determining proper management of these patients.

METHODS

Pathologic reports of native kidney biopsies performed for idiopathic proteinuria >3 g/24 h were reviewed. Clinical characteristics and biopsy findings were compared for individuals with serum albumin <30 g/L (Group I), 30 to <35 g/L (Group II) and >/=35 g/L (Group III).

RESULTS

There were 57 patients in Group I, 20 in Group II and 35 in Group III. The proportion of individuals with focal and segmental glomerulosclerosis (FSGS) increased according to group: 26% in Group I, 45% in Group II and 74% in Group III. Of 35 patients in Group III, 34 had FSGS or advanced nephrosclerosis from another cause. Seven of 17 Group III patients with follow-up required dialysis after a mean interval of 6 years. Few of these patients received immunosuppressive therapy.

CONCLUSIONS

As serum albumin increases in the nephrotic syndrome, the proportion of patients with FSGS increases. Patients with nephrotic proteinuria and a serum albumin >35 g/L suffer from FSGS, nephrosclerosis and have poor renal survival. When evaluating nephrotic patients, nephrologists should use this knowledge about the spectrum of disease in the clinical decision making of when to perform a biopsy and in providing the patient more precise information regarding risks, benefits and alternatives of the kidney biopsy procedure.

Authors+Show Affiliations

Section on Nephrology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27103, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18065791

Citation

Gupta, Karn, et al. "Distribution of Pathologic Findings in Individuals With Nephrotic Proteinuria According to Serum Albumin." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 23, no. 5, 2008, pp. 1595-9.
Gupta K, Iskandar SS, Daeihagh P, et al. Distribution of pathologic findings in individuals with nephrotic proteinuria according to serum albumin. Nephrol Dial Transplant. 2008;23(5):1595-9.
Gupta, K., Iskandar, S. S., Daeihagh, P., Ratliff, H. L., & Bleyer, A. J. (2008). Distribution of pathologic findings in individuals with nephrotic proteinuria according to serum albumin. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 23(5), 1595-9.
Gupta K, et al. Distribution of Pathologic Findings in Individuals With Nephrotic Proteinuria According to Serum Albumin. Nephrol Dial Transplant. 2008;23(5):1595-9. PubMed PMID: 18065791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distribution of pathologic findings in individuals with nephrotic proteinuria according to serum albumin. AU - Gupta,Karn, AU - Iskandar,Samy S, AU - Daeihagh,Pirouz, AU - Ratliff,Heather L, AU - Bleyer,Anthony J, Y1 - 2007/12/08/ PY - 2007/12/11/pubmed PY - 2008/6/13/medline PY - 2007/12/11/entrez SP - 1595 EP - 9 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 23 IS - 5 N2 - BACKGROUND: Previous studies of the nephrotic syndrome have not carefully examined the relationship between serum albumin and the distribution of pathologic diagnoses found at the time of biopsy. The spectrum of pathologic findings in individuals with nephrotic proteinuria and a normal serum albumin has not been determined. Knowledge regarding the spectrum of findings in nephrotic proteinuria according to serum albumin levels may help nephrologists in the clinical decision making of when to perform a renal biopsy and in determining proper management of these patients. METHODS: Pathologic reports of native kidney biopsies performed for idiopathic proteinuria >3 g/24 h were reviewed. Clinical characteristics and biopsy findings were compared for individuals with serum albumin <30 g/L (Group I), 30 to <35 g/L (Group II) and >/=35 g/L (Group III). RESULTS: There were 57 patients in Group I, 20 in Group II and 35 in Group III. The proportion of individuals with focal and segmental glomerulosclerosis (FSGS) increased according to group: 26% in Group I, 45% in Group II and 74% in Group III. Of 35 patients in Group III, 34 had FSGS or advanced nephrosclerosis from another cause. Seven of 17 Group III patients with follow-up required dialysis after a mean interval of 6 years. Few of these patients received immunosuppressive therapy. CONCLUSIONS: As serum albumin increases in the nephrotic syndrome, the proportion of patients with FSGS increases. Patients with nephrotic proteinuria and a serum albumin >35 g/L suffer from FSGS, nephrosclerosis and have poor renal survival. When evaluating nephrotic patients, nephrologists should use this knowledge about the spectrum of disease in the clinical decision making of when to perform a biopsy and in providing the patient more precise information regarding risks, benefits and alternatives of the kidney biopsy procedure. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/18065791/Distribution_of_pathologic_findings_in_individuals_with_nephrotic_proteinuria_according_to_serum_albumin_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfm833 DB - PRIME DP - Unbound Medicine ER -